晚期食道状细胞癌的免疫疗法:早或晚?
Shuang Wei1, Zuoji Li2, Tingting Liu3
1Department of Radiation Oncology, Gaomi People's Hospital, Weifang, China.
Frontiers in medicine
|July 24, 2025
概括
早期免疫疗法可以改善无进展生存率 (PFS),但不能改善晚期食道状细胞癌 (ESCC) 患者的整体生存率 (OS). 这一发现表明,在控制疾病方面可能有好处,但不会影响长期生存结果.
科学领域:
- 在瘤学瘤学.
- 免疫治疗是一种免疫疗法.
- 胃肠道瘤学 胃肠道瘤学
背景情况:
- 免疫疗法已在晚期食道癌 (EC) 中显示出生存益处.
- 在EC中启动免疫治疗的最佳时间仍然是一个研究领域.
- 这项研究探讨了早期与晚期免疫疗法启动对患者结果的影响.
研究的目的:
- 研究早期免疫疗法启动对局部晚期或转移性食道状细胞癌 (ESCC) 患者长期生存的影响.
- 在早期和晚期免疫疗法组之间比较整体存活率 (OS) 和无进展存活率 (PFS).
主要方法:
- 在2018年1月至2021年12月期间诊断出局部晚期或转移性ESCC的359名患者的回顾性分析.
- 患者被分为早期免疫疗法 (EIT) 组 (一线) 和晚期免疫疗法 (LIT) 组 (二线).
- 倾向性得分匹配 (1:1) 用于平衡基线特征,以 OS 为主要结果.
主要成果:
- 在倾向性得分匹配后 (每组107名患者),中位数的生存寿命为15.7个月 (EIT) 和17.7个月 (LIT) (p=0.185).
- 与LIT组 (7.6个月) 相比,EIT组 (8.7个月) 的无进展生存期 (PFS1) 显著改善 (p=0.032).
- 亚组分析表明特定患者人口统计和治疗方案的潜在益处;COX分析确定EIT和瘤分化影响OS.
结论:
- 在局部晚期或转移性ESCC中早期启动免疫疗法可以改善无进展生存率 (PFS).
- 早期免疫疗法在这个患者队列中没有显著影响整体存活率 (OS).
- 研究结果表明,虽然早期免疫疗法可以控制疾病的进展,但其对长期存活的影响需要进一步调查.
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