诱导放射化疗用于食道癌症:单中心研究的长期结果
Bartłomiej Strzelec1, Piotr Paweł Chmielewski2, Renata Taboła1
12nd Department of General Surgery and Surgical Oncology, Medical University Hospital, 50-556 Wroclaw, Poland.
Journal of clinical medicine
|January 25, 2025
概括
术前放射化疗 (CRT) 显著降低食道癌 (EC) 的发展阶段,特别是在男性中. 绝对CRT (dCRT) 为选定的患者提供了手术的可行替代方案,改善了治疗策略.
科学领域:
- 在瘤学瘤学.
- 胃肠病学 胃肠病学
- 手术瘤学手术瘤学
背景情况:
- 食道癌 (EC) 管理在优化治疗策略方面存在挑战.
- 术前放射化疗 (CRT) 是多模式EC治疗的关键组成部分.
- 确定受益于最终CRT (dCRT) 的子组对于个性化护理至关重要.
研究的目的:
- 评估手术前CRT对EC患者临床分期的影响.
- 确定dCRT可能是外科手术的有利替代方案的患者子组.
- 在拒绝手术的患者中评估dCRT的瘤控制.
主要方法:
- 61名EC患者接受了手术前的CRT (CROSS或dCRT协议).
- 分期包括CT,胃镜和实验室评估;手术包括食道切除或艾佛·易斯手术.
- 四名患者接受了dCRT而不是手术;通过pTNM和随访评估结果.
主要成果:
- 手术前的CRT显著减少了T阶段 (p=0.0002),完全病理反应率为54.5% (pT0N0M0).
- 男性患者表现出显著的T阶段减少 (p=0.0008).
- 在四年内,dCRT在非手术候选人中提供了可接受的瘤控制.
结论:
- 手术前的CRT有效地降低了EC,并产生了很高的响应率,特别是在男性中.
- 对于被选中的EC患者来说,dCRT是手术的潜在替代方案.
- 个性化治疗策略和精细的多式联络方法对于优化EC护理至关重要.
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