在新辅助化疗或放射治疗后,病理完整反应与食道癌的长期存活有关:系统性审查和元分析
Jiajing Sun1,2, Cien Sun3,4, Ying Zhang3,4
1Taizhou Hospital, Zhejiang University School of Medicine, Taizhou, China.
BMC surgery
|July 16, 2025
概括
在新辅助化学放射治疗 (NCRT) 后,病理完整反应 (pCR) 显著改善了食道癌患者的长期存活率. 这一发现支持pCR作为评估NCRT有效性的可靠替代终点.
科学领域:
- 在瘤学瘤学.
- 胃肠病学 胃肠病学
- 手术瘤学手术瘤学
背景情况:
- 新辅助化学放射疗法 (NCRT) 是局部晚期食道癌的标准治疗方法.
- 病理完整反应 (pCR) 作为长期存活的替代终点的作用仍在研究中.
研究的目的:
- 评估pCR与食道癌患者的长期存活率之间的关联,这些患者接受了NCRT和手术治疗.
- 确定pCR是否可以作为NCRT疗效的替代终点.
主要方法:
- 在2024年2月进行了系统的文献搜索.
- 对38项研究的元分析,包括接受新辅助治疗的可切除食道癌患者.
- 随机效应或固定效应模型被用于分析整体存活率 (OS) 和无病存活率 (DFS) 数据.
主要成果:
- 在食道癌患者中,pCR显著与改善的OS (HR=0.54) 和DFS (HR=0.51) 相关.
- 亚组分析显示,通过组织学分层 (状细胞癌和腺癌) 实现pCR的患者的生存益处更大.
- 食道状细胞癌 (ESCC) 的pCR率较高;瘤位于上/中食道的位置也与较高的pCR相关.
结论:
- 在NCRT之后的pCR是食道癌中长期存活的重要预测因素.
- pCR是一种可行的替代终点,用于评估新辅助化学放射治疗在食道癌症中的生存结果.
更多相关视频
06:46Competing-Risk Nomogram for Predicting Cancer-Specific Survival in Multiple Primary Colorectal Cancer Patients after Surgery
Published on: September 27, 2024
380
09:40An Ivor Lewis Esophagectomy Designed to Minimize Anastomotic Complications and Optimize Conduit Function
Published on: April 17, 2020
13.8K
相关概念视频
Barrett Esophagus-II: Clinical Manifestations and Management
314
Individuals with Barrett's esophagus are often asymptomatic, but they may experience symptoms commonly associated with GERD, such as heartburn and acid regurgitation. Additional symptoms can include difficulty swallowing, chest pain, unintentional weight loss, blood in the stool (which may appear black, tarry, or bloody), and episodes of vomiting.
To diagnose Barrett's esophagus, healthcare providers often recommend an endoscopy for those showing symptoms of acid reflux. The procedure...
To diagnose Barrett's esophagus, healthcare providers often recommend an endoscopy for those showing symptoms of acid reflux. The procedure...
314
Treatment Resistant Cancers
3.4K
Cancer is the second leading cause of death in the United States. A cancer cell is genetically unstable and hence can mutate faster. They can also modify their microenvironment and escape immune surveillance. The difficulties in treating cancer are further compounded by the emergence of rapid resistance to anticancer drugs. The most common ways to attain resistance in cancer cells include alteration in drug transport and metabolism, modification of drug target, elevated DNA damage response, or...
3.4K
Esophageal Varices-II: Clinical Features and Management
146
Esophageal varices often manifest as gastrointestinal bleeding episodes, presenting symptoms like hematemesis (vomiting of blood), hematochezia (passing fresh blood via the rectum), and melena (black, tarry stools). Other signs can include weight loss, anorexia, abdominal discomfort, jaundice, pruritus, altered mental status, and muscle cramps.
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol...
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol...
146
Cancer Survival Analysis
456
Cancer survival analysis focuses on quantifying and interpreting the time from a key starting point, such as diagnosis or the initiation of treatment, to a specific endpoint, such as remission or death. This analysis provides critical insights into treatment effectiveness and factors that influence patient outcomes, helping to shape clinical decisions and guide prognostic evaluations. A cornerstone of oncology research, survival analysis tackles the challenges of skewed, non-normally...
456
