新辅助化疗免疫治疗后食道状细胞癌的辅助免疫疗法:一个多中心的现实研究
Chunji Chen1, Ziqiang Tian2, Jiangbo Lin3,4,5
1Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
International journal of surgery (London, England)
|September 24, 2025
概括
在新辅助化疗免疫疗法 (NCIT) 后的辅助免疫疗法没有改善食道状细胞癌 (ESCC) 患者的生存率. 然而,它有利于那些治疗后有残留疾病的人.
科学领域:
- 在瘤学瘤学.
- 免疫治疗是一种免疫疗法.
- 胃肠道癌症研究研究
背景情况:
- 辅助免疫疗法在食道状细胞癌 (ESCC) 化疗后的治疗中显示出有前途.
- 在ESCC中,继新辅助化学免疫疗法 (NCIT) 之后的辅助免疫疗法的作用仍然不清楚.
- 需要真实世界的数据来评估这种特定患者群体的生存益处.
研究的目的:
- 评估辅助免疫疗法对ESCC患者的生存益处,这些患者接受了NCIT,随后进行了R0切除.
- 评估辅助免疫治疗对这一队列的整体存活率 (OS) 和无病存活率 (DFS) 的影响.
- 确定可能从辅助免疫疗法中受益的患者子组.
主要方法:
- 一项多中心的回顾性研究,包括724名接受NCIT和R0切除的ESCC患者.
- 倾向性得分匹配 (PSM) 用于平衡每组262名患者:NCIT + 手术 (NCIT + S) 与NCIT + 手术 + 辅助免疫疗法 (NCIT + S + ICI).
- 主要终点包括2年的OS和DFS;次要终点关注复发模式.
主要成果:
- 在PSM后的分析显示,两组之间2年后的OS (80.0%对84.5%) 或DFS (77.7%对72.6%) 没有显著差异.
- 辅助免疫疗法与改善的OS或DFS没有独立相关.
- 亚组分析表明,对于非微观残留疾病 (非MPR) 和非病理完整响应 (非pCR) 的患者,存在显著的OS益处.
结论:
- 辅助免疫疗法在接受NCIT治疗的ESCC总体队列中没有提供生存优势.
- 在NCIT后残留瘤 (非MPR/非pCR) 的患者可能受益于辅助免疫疗法.
- 需要进一步的研究,以优化患者选择辅助免疫疗法在这种情况下.
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