治疗食道状细胞癌的额外化疗的结果,在未治愈的内镜下膜剖析后
Yujiro Adachi1, Yoshito Hayashi2, Shinji Yoneda1
1Department of Gastroenterology and Hepatology, The University of Osaka Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan.
对于食道状细胞癌 (ESCC) 患者,在内镜下粘膜切割 (ESD) 后具有高风险因素,化疗提供了比化疗放射治疗更安全,更有效的治疗选择,从而提高了生存率和减少并发症.
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:
- 淋巴血管侵袭的T1a-肌肉粘膜和T1b-亚粘膜是食道状细胞癌 (ESCC) 淋巴结转移的高风险因素.
- 标准治疗包括食管切除和化学放射治疗后内镜下粘膜切割 (ESD),但这可能导致并发症.
- 评估替代辅助疗法对于改善患者治疗结果至关重要.
研究的目的:
- 为了比较化疗与化疗放射治疗作为ESD后辅助治疗的疗效和安全性,在ESCC患者中进行高风险的病理发现.
- 评估两组治疗之间的总生存率,因果特定生存率,无复发生存率和不良事件的差异.
主要方法:
- 一项前性和后性研究包括患有病态T1a-muscularis粘膜与淋巴血管侵入或T1b-亚粘膜的患者,他们接受了食道ESD.
- 患者在ESD后接受了化疗或化疗放射治疗.
- 关键结局包括生存率,住院时间和≥3级不良事件进行了比较.
主要成果:
- 化疗组 (n=16) 与化疗或放射治疗组 (n=15) 相比,显示出明显更高的5年整体存活率 (100.0%vs77.8%) 和无复发存活率 (92.3%vs84.9%).
- 在化疗组中,住院时间显著缩短 (34 vs. 48天),并且3级以上的不良事件较少发生 (25.0% vs. 73.3%).
- 两组之间因特定原因的5年生存时间没有显著差异.
结论:
- 在ESD之后的辅助化疗是ESCC患者的安全和有效治疗方法,患者患有病态T1a-muscularis粘膜与淋巴血管侵入或T1b-submucosa.
- 化疗在这个患者队列中显示出优越的生存结果和更好的安全概况,与化疗放射治疗相比.
- 这些发现支持化疗作为选择ESCC患者在ESD后的首选辅助治疗策略.
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