提高局部晚期食道癌的生存率:使用SEER数据库对新辅助免疫疗法与传统新辅助疗法的比较分析
Qinyong Tian1, Jingping Lin2, Liudan Hu3
1Department of Cardiothoracic Surgery, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, China.
Journal of thoracic disease
|June 18, 2025
概括
新辅助免疫疗法 (NAI) 当与手术相结合时,可显著改善晚期食道癌患者的生存率. 与传统疗法相比,这种方法提供了更好的整体和癌症特异性存活率.
科学领域:
- 在瘤学瘤学.
- 免疫治疗是一种免疫疗法.
- 手术瘤学手术瘤学
背景情况:
- 局部发达的食道癌是一个重大的临床挑战.
- 新辅助性免疫检查点抑制剂 (ICI) 正成为一个有前途的治疗策略.
- 研究的重点是了解新辅助免疫疗法 (NAI) 的生存益处.
研究的目的:
- 评估新辅助免疫疗法 (NAI) 与常规新辅助疗法 (CNAT) 对局部晚期食道癌患者的生存益处.
- 为了确定影响这种患者群体生存的预后因素.
- 为了评估与手术结合的NAI的疗效.
主要方法:
- 利用监测,流行病学和最终结果 (SEER) 数据库进行全面分析.
- 包括2004-2014年至2019-2020年期间诊断的3,708名患者,分为NAI和CNAT组.
- 采用卡普兰-梅尔分析,考克斯回归,倾向得分匹配 (PSM) 和治疗权重的逆概率 (IPTW) 来评估总生存率 (OS) 和癌症特异性生存率 (CSS).
主要成果:
- 与CNAT组相比,NAI组显示了与CNAT组相比显著改善的OS和CSS (P<0.05).
- 确定的独立预后因素包括性别,年龄,瘤大小,等级,SEER总结阶段和治疗方式.
- 女性患者和NAI接收与更好的预后有关;年龄较大,瘤较大,更高的等级和区域阶段是危险因素. 已婚患者和患有较大的瘤 (>60毫米) 患者从NAI中获得更大的生存益处.
结论:
- 新辅助免疫疗法与手术相结合,显著提高了局部晚期食道癌的生存结果.
- 这些发现支持将免疫治疗剂纳入新辅助治疗方案.
- 这项研究为未来的临床策略和食道癌症管理研究提供了基础.
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