早期直肠癌的全新辅助疗法:一个多中心前性队列研究
Sergei Bedrikovetski1,2, Ishraq Murshed1,2, Tracy Fitzsimmons1,2
1Discipline of Surgery, Faculty of Health and Medical Sciences, School of Medicine, University of Adelaide, Adelaide, South Australia, Australia.
概括
早发性直肠癌 (EORC) 显示了与标准年龄直肠癌 (AORC) 具有全新辅助疗法 (TNT) 的类似治疗反应. EORC患者的化学疗法毒性较小,但辐射毒性较大.
科学领域:
- 在瘤学瘤学.
- 胃肠病学 胃肠病学
- 临床研究 临床研究
背景情况:
- 全球早期直肠癌 (EORC) 发病率正在上升,通常在晚期被诊断出来.
- 总的新辅助疗法 (TNT) 改善了晚期直肠癌的结果.
- 在EORC与平均发作的直肠癌 (AORC) 中,TNT的有效性尚未确定.
研究的目的:
- 为了比较EORC和AORC患者中TNT的治疗反应和毒性.
- 评估整体完整反应 (oCR) 率,包括临床完整反应 (cCR) 和病理完整反应 (pCR).
- 评估EORC和AORC队列之间的治疗合规性和毒性概况.
主要方法:
- 在南澳大利亚三家医院连续治疗TNT (2019-2024) 的直肠癌患者的回顾性分析.
- 患者被分为EORC (<50岁) 和AORC (≥50岁) 两组.
- 主要结果:oCR率. 二次结果:合规性和与治疗相关的毒性 (化疗和放射治疗).
主要成果:
- 包括202名患者:48名 (23.8%) 的EORC和154名 (76.2%) 的AORC.
- 在EORC和AORC之间的oCR率没有显著差异 (43.8%与37.9%,P=0.470).
- 在EORC患者中,化学疗法毒性3-4级较少 (2.1%与25.3%,P<0.001),但更多患者报告了3-4级辐射毒性 (31.3%与12.3%,P=0.004).
结论:
- 在接受TNT治疗时,EORC患者的整体瘤应答率与AORC患者相似.
- 在EORC和AORC组之间,毒性概况有很大的差异.
- EORC患者更好地忍受化疗,但患者报告的辐射毒性更大.
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