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通过额外的免疫疗法改善了食道状细胞癌的无复发生存率:多中心队列研究

Shuhan Xie^1,2,3,4,5,6, Hui Xu^1,2,3,4,5,6, Jinxin Xu⁷

¹Department of Thoracic Surgery, Fujian Medical University Union Hospital, Fuzhou, China.

Surgical endoscopy

|August 25, 2025

概括

在局部晚期食道状细胞癌 (LA- ESCC) 患者中,将免疫疗法添加到新辅助化疗 (nICT) 显著改善了生存结果. 这种增强的治疗策略在手术后的第一个18个月内对远程无转移的生存有特别的益处.

科学领域:

癌症学
医学研究
临床试验

背景情况:

免疫疗法对食道状细胞癌 (ESCC) 是有前途的.
在局部晚期ESCC (LA-ESCC) 免疫治疗的长期生存益处需要进一步评估.
本研究评估了新辅助化疗 (nCT) 添加免疫治疗对ESCC患者的生存的影响.

研究的目的:

评估新辅助化学免疫疗法 (nICT) 与新辅助化学疗法 (nCT) 对LA- ESCC患者的生存影响.
为了比较无复发存活率 (RFS),局部无复发存活率 (L-RFS) 和远程无转移存活率 (D-MFS).
使用倾向分数匹配 (PSM) 和治疗权重的逆概率 (IPTW) 分析生存差异.

主要方法:

在五个医疗中心对273名LA-ESCC患者进行了比较研究,他们接受了nICT或nCT.
没有复发的生存率 (RFS) 是主要终点;L-RFS和D-MFS是次要终点.
统计分析包括PSM,IPTW和使用卡普兰-梅尔曲线的18个月里程碑式分析.

主要成果:

nICT显著改善了病理反应,并且是改善预后的独立因素 (HR=3. 05, p< 0. 001).
在PSM/IPTW调整之前和之后,nICT表现出优异的RFS和D-MFS,并趋向于改进L-RFS.
一个18个月的基准分析证实了nICT对RFS,L-RFS和D-MFS的显著增强,特别是在ypStage III/ IV疾病的患者中.

结论:

新辅助化学免疫疗法 (nICT) 显著改善LA- ESCC患者的预后结果.
在远程无转移存活期 (D-MFS) 和早期术后存活期 (前18个月) 中显示出显著的益处.
对于LA-ESCC来说,nICT可能是一个更有效的治疗策略,因此需要进一步的研究.

关键词:

没有远程转移的存活率地区性无复发生存率新辅助化学免疫疗法新辅助化疗没有复发的生存率尾部效应

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