评估切除胃癌的生存结果和治疗建议
Saad Sabbagh1, Iktej Singh Jabbal2, María Herrán1
1Department of Hematology-Oncology, Maroone Cancer Center, Cleveland Clinic Florida, Weston, FL, 33331, USA.
Scientific reports
|January 22, 2025
概括
术后化学疗法 (PC) 与胃和胃食道结癌的总体存活率更好有关. 然而,PC的使用仍然很低,尽管它与化学放射治疗等其他治疗方法相比有效.
科学领域:
- 在瘤学瘤学.
- 手术瘤学手术瘤学
- 胃肠道瘤学 胃肠道瘤学
背景情况:
- 切除胃癌 (GC) 和胃食道结 (GEJ) 瘤的最佳治疗方法缺乏共识.
- 化学辐射疗法与外科手术前化学疗法 (PC) 的比较有效性正在争论中.
研究的目的:
- 为了在GC和GEJ瘤中比较不同治疗方式的整体生存 (OS) 结果.
- 从2010年到2020年评估GC和GEJ瘤的治疗趋势.
主要方法:
- 对≥cT2非转移性GC和GEJ癌症患者的国家注册表队列的分析.
- 治疗方式的分类:新辅助化疗 (NC),新辅助化疗 (NCR),PC,辅助化疗 (AC) 和辅助化疗 (ACR).
- 使用卡普兰-梅尔曲线和多变量考克斯回归模型来评估与OS相关的因素.
主要成果:
- 术后化学疗法 (PC) 与最高的整体存活率 (中位数为86.80个月) 相关.
- 与PC和NC相比,化疗辐射疗法 (新辅助剂或辅助剂) 的生存状况更差.
- 新辅助化学辐射疗法 (NCR) 和新辅助化学疗法 (NC) 的存活率比PC更差 (HR分别为1.74和1.26).
- 新辅助化疗 (NC) 是2020年使用最多的疗法 (35.8%),其次是PC (28.0%).
- 在2010年至2020年期间,PC和NC的使用量增加了11.0%.
结论:
- 周围手术化疗 (PC) 与非转移性GC和GEJ瘤的整体生存结果的改善有关.
- 涉及放射化疗和扩展淋巴结解剖的治疗与PC和NC相比,与更糟糕的预后相关.
- 尽管结果有所改善,但国家数据显示PC的利用率很低.
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