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不完整的新辅助化疗和放射治疗对局部晚期食道癌的病理反应和整体存活率产生负面影响

Denice Kamp¹, Samuel Noya², Stella Mook³

¹Department of Epidemiology and Health Economics, Julius Center, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands.

European journal of cancer (Oxford, England : 1990)

|June 5, 2025

概括

在新辅助化学辐射 (nCRT) 期间的不完整化疗显著降低了食道腺癌 (OAC) 中的病理完整反应 (pCR) 率. 这也导致OAC患者的整体存活率 (OS) 比完成治疗的患者更差.

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:

新辅助化学辐射 (nCRT) 随后切除是食道和胃食道结癌的标准治疗方法.
在接受nCRT的患者中,不总是能够完成全部化疗方案.
了解不完整化疗对治疗结果的影响对于优化患者护理至关重要.

研究的目的:

评估不完整的新辅助化学辐射化疗和病理完整反应 (pCR) 之间的关联.
评估不完全化疗对食道腺癌 (OAC) 和状细胞癌 (OSCC) 患者整体存活期 (OS) 的影响.
根据化疗完成状态,识别治疗反应的潜在差异.

主要方法:

一项全国范围的队列研究确定了在2015年至2022年期间用nCRT和食道切除术治疗OAC和OSCC的患者.
多变量逻辑回归分析了化疗完成和pCR之间的关联.
卡普兰-梅尔和考克斯回归模型被用来调查OS,调整混因素.

主要成果:

在食管腺癌 (OAC) 中,不完整的化疗 (10%) 与显著较低的pCR几率 (15%与21%) 和更差的中位数整体存活率 (31.8与42个月) 相关.
在食道状细胞癌 (OSCC) 中没有观察到不完整化疗和pCR或OS之间的显著关联.
该研究包括3340名OAC患者和685名OSCC患者.

结论:

在nCRT疗法中不完全进行化疗与食管腺癌患者的癌症结果较差有关,特别是减少pCR和OS.
治疗完成似乎是一个关键因素,以实现最佳的结果在OAC治疗的nCRT.
这些发现强调了在OAC管理中遵守化疗方案的重要性.

关键词:

完成化疗疗法的完成.食道癌是食道癌的一个类型.新辅助剂化学辐射疗法病理完整的反应病理完整的反应现实世界的数据数据.幸存的生存方式

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