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瘤对新辅助药的反应 长期化学放射治疗 取决于直肠癌患者的性别
Velda Smajlbegović, Snježana Ramić, Iva Kirac1
1Surgical Oncology, University Hospital for Tumors, Sestre milosrdnice University Hospital Center, Zagreb, Croatia.
Acta clinica Croatica
|October 16, 2025
概括
在新辅助化疗或放射治疗后,性别影响直肠癌的结果. 与男性相比,女性的治疗反应和无病生存率 (DFS) 较差,这表明需要针对性别的治疗策略.
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:
- 新辅助性长期化学放射治疗 (LCCRT) 是直肠癌的标准治疗方法.
- 了解对LCCRT的性别特异反应对于优化治疗至关重要.
- 以前的研究还没有完全阐明治疗疗效和存活时间的基于性别的差异.
研究的目的:
- 为了研究与癌症相关的参数,瘤回归度 (TRG) 和按性别分层的无疾病生存率 (DFS) 之间的相关性.
- 为了确定对直肠癌的新辅助疗法的反应中潜在的性别特异性差异.
- 为男性和女性直肠癌患者制定量身定制的治疗方法提供信息.
主要方法:
- 对192名接受LCCRT治疗的直肠癌患者的回顾性分析.
- 评估手术前临床参数,包括肥胖和性别.
- 评估LCCRT后的病理发现:瘤回归度 (TRG),淋巴结状况 (ypN),瘤入侵深度 (ypT) 和切除边缘.
- 根据性别进行统计分析,以确定参数和DFS之间的相关性.
主要成果:
- 除了肥胖之外,没有观察到明显的手术前性别差异.
- 在LCCRT后,女性的阳性淋巴结 (ypN) 率更高.
- 与男性相比,女性的TRG和DFS较差,即使治疗反应完全.
- 阳性切除边缘,较高的ypN和较差的TRG与男性较短的DFS有关.
结论:
- 女性在直肠癌中表现出较差的LCCRT反应和更糟糕的DFS.
- 病理参数,如ypN和TRG显著影响DFS,与性别特定的变化.
- 这些发现表明,直肠癌的新辅助治疗策略可能需要以性别为特征.
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