非cisplatin同时使用的药物加上局部晚期头癌的终极放射治疗:随机研究的网络元分析
Fausto Petrelli1, Francesca Trevisan2, Massimiliano Nardone3
1Oncology Unit, ASST Bergamo Ovest, Piazzale Ospedale 1, 24047 Treviglio, BG, Italy.
概括
基于西斯的化疗放射治疗是头癌的标准治疗方法,但替代方案,如米托米辛C和多塞塔克塞尔,对无法接受西斯的患者来说是有前途的,改善了生存和控制.
科学领域:
- 在瘤学瘤学.
- 辐射疗法 辐射疗法
- 医学瘤学 医学瘤学
背景情况:
- 头部和部状细胞癌 (HNSCC) 是一个挑战,特别是在晚期.
- 基于西斯普拉丁的化疗放射治疗 (CRT) 提供了生存益处,但具有显著的毒性.
- 目前正在探索用于HNSCC治疗的替代药物.
研究的目的:
- 为了比较非cisplatin全身疗法的疗效和安全性与HNSCC的最终放射治疗 (RT).
- 为那些无法耐受西斯的患者确定最佳的治疗策略.
主要方法:
- 29个随机对照试验的网络元分析 (NMA).
- 将最终的RT与非青的全身疗法与基于青的疗法相结合.
- 评估整体生存 (OS),无进展生存 (PFS) 和局部区域控制 (LRC).
主要成果:
- 基于西斯普拉丁的疗法显示出更高的生存状况.
- 基于米托米辛C的疗法和每周的多塞塔克塞尔+RT疗法在PFS和LRC方面表现出高效.
- 塞图西马布和免疫检查点抑制剂 (ICI) +RT在疗效方面排名最低.
结论:
- 卡博普拉丁,以米托米辛C为基础的,以及每周服用多塞塔塞尔+RT,对于特定的HNSCC患者来说,它们是西斯普拉丁的可行替代品.
- 定制的治疗策略对于改善HNSCC的结果至关重要.
- 对非思丁治疗方案的进一步研究是有必要的.
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