新辅助化学免疫疗法与非小细胞肺癌的化学放射疗法:临床结果和病理反应的比较分析
Ji Hyeon Park1, Ki-Chang Lee2, Sangjun Lee1
1Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul, Republic of Korea.
Journal of thoracic disease
|October 29, 2025
概括
新辅助化学放射疗法 (neoCCRT) 和化学免疫疗法 (neoCIT) 在局部晚期非小细胞肺癌 (NSCLC) 中显示出相似的生存率和安全性. 新型CCRT改善了主要病理反应,但没有改善整体存活率.
科学领域:
- 在瘤学瘤学.
- 胸部外科手术 胸部外科手术
- 医学瘤学 医学瘤学
背景情况:
- 新辅助化疗免疫疗法 (neoCIT) 正在获得当地晚期非小细胞肺癌 (NSCLC) 的吸引力.
- 在neoCIT和neoadjuvant同时化学辐射疗法 (neoCCRT) 之间缺乏直接比较,这造成了临床困境.
- neoCIT和neoCCRT都有不同的机制,疗效和安全性.
研究的目的:
- 在局部晚期NSCLC患者中比较neoCIT和neoCCRT之间的临床结果和病理反应.
- 评估两种不同的NSCLC新辅助治疗策略的疗效和安全性.
- 根据比较数据为NSCLC的治疗选择提供信息.
主要方法:
- 对71名局部晚期NSCLC患者的回顾性分析,这些患者接受了neoCCRT (n=38) 或neoCIT (n=33),随后进行了手术.
- 使用国际肺癌研究协会标准评估病理反应.
- 术后并发症,复发率和生存结果的比较.
主要成果:
- 虽然基线特征平衡,但组织学在各组之间存在差异 (在neoCIT中状,在neoCCRT中非状).
- 新CCRT显示显著更高的主要病理反应 (MPR) 率 (55.3%对30.3%,P=0.03),但类似的病理完整反应率.
- 两组之间在两年复发率,术后并发症或生存结果方面没有发现显著差异.
结论:
- 新辅助药同步化学放射治疗和化学免疫治疗在局部发达的NSCLC中表现出可比的安全性和存活率.
- 使用新CCRT的更高的MPR率并没有转化为更好的生存结果.
- 建议根据瘤负担,组织学和转移风险进行个性化治疗选择.
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