新辅助化疗免疫治疗可切除头部和部状细胞癌:系统性审查和元分析
Lei-Ming Cao1, Yi-Fu Yu1, Zi-Zhan Li1
1State Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School and Hospital of Stomatology, Wuhan University, Wuhan, China.
Annals of surgical oncology
|March 19, 2025
概括
新辅助化疗免疫疗法在可切除头部和部状细胞癌 (HNSCC) 中显示出显著的病理反应. 20或更高的综合阳性得分 (CPS) 可以预测治疗灵敏度,有助于患者选择这种有效疗法.
科学领域:
- 在瘤学瘤学.
- 免疫治疗是一种免疫疗法.
- 头部和部癌症研究研究
背景情况:
- 新辅助化疗免疫疗法在可切除的头部和部状细胞癌 (HNSCC) 中显示出有效性.
- 现有的研究缺乏全面的系统审查来评估治疗的有效性.
- 这项研究综合了证据,提供了关于HNSCC新辅助化学免疫治疗的更高水平数据.
研究的目的:
- 系统地审查和综合新辅助化学免疫治疗在可切除HNSCC的患者的疗效.
- 评估病理反应率和整体生存结果.
- 探索治疗反应的预测标记和诊断工具.
主要方法:
- 在主要数据库 (PubMed, Web of Science, Scopus, EBSCO) 和临床试验注册表中进行了系统的文献搜索.
- 包括2015年1月至2024年7月期间发表的研究.
- 使用随机效应模型的元分析综合了主要病理反应 (MPR),病理完整反应 (pCR),无病生存率 (DFS) 和综合阳性得分 (CPS) 和放射性反应的实用性.
主要成果:
- 分析了13项涉及458名接受新辅助化疗免疫治疗的患者的研究.
- 对于MPR,pCR和DFS的聚合率分别为61%,37%和91%.
- 一个CPS≥20与MPR的2.09概率比率有关. 放射学客观反应显示0.91的灵敏度和0.46的特异性预测MPR (AUC=0.76).
结论:
- 新辅助化学免疫疗法对可切除的HNSCC.提供了有前途的结果.
- 一个CPS≥20可以识别可能对治疗有反应的患者.
- 放射性评估可以帮助检测病理反应,尽管需要进一步验证和更长的随访.
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