在手术前管理局部晚期癌的新辅助系统疗法 系统性审查和元分析
Ximena Guzman Robledo1, Herney Andrés García-Perdomo1
1Division of Urology/Uro-oncology, Department of Surgery, School of Medicine, Universidad del Valle, Cali, Colombia.
概括
新辅助全身疗法对局部晚期瘤具有前途,约三分之一的患者经历瘤回归. 这种方法对于接受切除术的高风险个人来说是安全的和可行的.
科学领域:
- 在瘤学瘤学.
- 腎臟病學 (nephrology) 是一種醫學專業.
- 手术瘤学手术瘤学
背景情况:
- 局部发达的瘤 (≥T3或N1) 是一个高风险的手术挑战.
- 正在探索新辅助性全身疗法,以改善切除术前的结果.
研究的目的:
- 评估新辅助全身治疗在局部晚期瘤患者中的有效性和安全性.
- 评估在新辅助治疗后的生存,瘤反应和手术可行性.
主要方法:
- 从临床试验,准实验研究和队列研究中对比例的元分析.
- 包括接受切除术的当地晚期癌的成年患者.
- 主要结局包括癌症特异性生存率 (CSS),总生存率 (OS),无进展生存率 (PFS) 和无疾病生存率 (DFS).
主要成果:
- 九项研究用于定性综合,七项用于元分析.
- 瘤大小的减少范围从-50%到+7.9%.
- 26%的患者 (95% CI 15-42) 观察到部分反应.
结论:
- 新辅助疗法在局部晚期瘤患者中的大约三分之一中显示出积极的临床瘤回归.
- 这种治疗被认为是可行的,并且对这种高危人群来说是安全的.
- 进一步的研究可能会优化癌的新辅助策略.
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