老年患有食道状细胞癌的老年患者的最佳治疗策略:一个多中心的回顾性研究
Yuta Sato1, Yoshihiro Tanaka1, Ritsuki Takaha1
1Department of Gastroenterological Surgery and Pediatric Surgery, Gifu University Graduate School of Medicine, Gifu, Gifu 501-1194, Japan.
Oncology letters
|February 6, 2025
概括
对于患有食道状细胞癌 (ESCC) 的老年患者,两周一次的多塞塔塞尔,西斯和5-甲 (DCF) 新辅助化疗 (NAC) 并没有改善整体存活率. 然而,NAC可能会延长低psoas肌肉指数 (PMI) 的患者的整体生存期.
科学领域:
- 在瘤学瘤学.
- 老年医学 老年医学
- 手术瘤学手术瘤学
背景情况:
- 对患有食道状细胞癌 (ESCC) 的老年患者的治疗策略需要澄清.
- 使用多塞塔克塞尔,思普拉丁和5-甲 (DCF) 的新辅助化疗 (NAC) 是一种潜在的选择.
- 肌指数 (PMI) 在预测老年ESCC患者治疗反应中的作用正在研究中.
研究的目的:
- 为了比较新辅助化疗 (NAC) 的疗效,使用分剂两周一次的多塞塔克塞尔,西斯普拉丁和5-甲 (DCF) 治疗方案与前期手术 (US) 在患有ESCC的70岁以上的患者中.
- 为了研究psoas肌肉指数 (PMI) 对该患者群体治疗结果的影响.
主要方法:
- 从2015年1月至2021年12月期间接受食道切除术的70岁以上的ESCC患者的多中心数据的回顾性分析.
- 接受NAC (n=47) 和接受US (n=39) 的患者之间结局的比较.
- 使用反向概率权重分析调整混因素,PMI作为一个关键的背景因素.
主要成果:
- 在NAC和美国组之间没有观察到3年总生存 (OS) 或无复发生存 (RFS) 的显著差异 (OS HR:0.576,P=0.325;RFS HR:0.483,P=0.141).
- 在PMI较低的患者中,NAC组与美国组相比显示显著延长3年的生存期 (HR:0.342,P=0.015).
- 两周一次的DCF治疗方案并没有改善老年ESCC患者的整体预后,但可能会延长低PMI患者的OS.
结论:
- 作为NAC的分剂两周一次的DCF疗法通常不会改善ESCC老年患者的预后.
- 低PMI可能会识别出老年ESCC患者的一个子组,他们可以从这种NAC疗法中受益,可能延长OS.
- 需要进一步的前性研究来验证这些发现,并优化老年ESCC患者的治疗策略.
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