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针对局部晚期直肠癌的不同新辅助化学放射疗法的最佳选择:系统性审查和网络元分析

Lian Liu¹, Guangyu Yao¹, Junhao Yang¹

¹Cancer Medical Center, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No. 41 Damucang Hutong, Xicheng District, Beijing, 100032, China.

Cancer metastasis reviews

|July 23, 2025

概括

总的新辅助化疗 (cTNT) 疗法,特别是CapOX cTNT,在局部晚期直肠癌 (LARC) 中显示出优异的病理完整反应 (pCR) 率. 巩固cTNT也改善了这些患者的长期生存结果.

科学领域:

在瘤学瘤学.
胃肠病学胃肠病学
临床试验临床试验

背景情况:

局部晚期直肠癌 (LARC) 需要有效的新辅助治疗来改善结果.
微卫星稳定 (MSS) LARC构成一个重要的患者群体.
新辅助化学辐射疗法 (NACRT) 是一种标准方法,但正在探索新的方法.

研究的目的:

为了比较局部晚期直肠癌 (LARC) 的不同新辅助化学放射治疗 (NACRT) 模式的病理完整反应 (pCR) 和存活率.
与标准NACRT相比,评估全新辅助化疗 (cTNT) 和综合免疫疗法 (iTNT) 的疗效.

主要方法:

对主要数据库 (PubMed,科学网,CENTRAL,Embase) 和会议摘要进行了系统的搜索.
包括随机对照试验 (RCT) 和涉及 11,658 名 MSS LARC 患者的晚期突破摘要.
进行了网络元分析,以比较各种NACRT疗法,包括cTNT和iTNT.

主要成果:

卡波克斯cTNT显示了最高的pCR率.
通过两次CapOX/FOLFOX cTNT的整合,实现了最佳的5年整体存活率 (OS).
通过6个周期的FOLFOX cTNT进行整合,导致了最好的5年无病生存期 (DFS).
与cTNT相比,iTNT在pCR中的益处较小.
对iTNT的不良事件通常是可以管理的.

结论:

包括CapOX和mFOLFIRINOX在内的cTNT疗法在MSS LARC中显著改善了pCR.
巩固cTNT为实现长期生存提供了优势.
进一步研究优化cTNT和在特定环境中探索iTNT是有必要的.

关键词:

局部发达的直肠癌局部发达的直肠癌在TNT上播放.在 pCR 中,pCR 值为 pCR.

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