在非小细胞肺癌中,新辅助化学免疫疗法在现实世界中的术后结果
Giorgio Caturegli1, Michael F Kaminski1, Maureen Canavan1
1Division of Thoracic Surgery, Department of Surgery, Yale School of Medicine, New Haven, Conn.
JTCVS open
|December 31, 2025
概括
新辅助化疗免疫疗法在非小细胞肺癌患者中显示出有希望的现实结果,死亡率较低,结果比单独化疗更好. 这种方法显示出显著的下降阶段效应和高的病理完整反应率,验证了其在一般人群中的使用.
科学领域:
- 在瘤学瘤学.
- 胸部外科手术 胸部外科手术
- 癌症研究 癌症研究
背景情况:
- 手术后非小细胞肺癌 (NSCLC) 复发影响大约30%的患者.
- 新辅助化疗免疫疗法在临床试验中显示出降低NSCLC复发的前景.
- 现实世界的数据对于验证不同患者群体的试验结果至关重要.
研究的目的:
- 评估新辅助化学免疫疗法在NSCLC患者的现实世界外科手术前期结果.
- 为了在现实世界中比较新辅助化学免疫疗法与化疗和化疗放射治疗的结果.
主要方法:
- 从国家癌症数据库对在2018-2022年间被诊断出临床I-III期NSCLC的成年患者进行了回顾性分析.
- 患者被分为三个组:新辅助化学免疫疗法,新辅助化学疗法或新辅助化学放射疗法.
- 评估了术后结果,包括肺切除率,90天死亡率,节点下降阶段和病理完整反应.
主要成果:
- 与化疗 (10.0%,P=.001) 相比,新辅助化疗免疫疗法 (n=1051) 与较低的肺切除率 (6.2%) 相关.
- 术后90天死亡率显著降低 (<1.0%) 化学免疫疗法与化疗 (2.0%,P<.001) 和化学辐射疗法 (3.5%,P<.001).
- 结节下降发生在43.9%的化疗免疫治疗患者中,病理完整反应发生在30.2%的化疗免疫治疗患者中,其表现优于化疗,与化疗或放射治疗相当.
结论:
- 现实数据支持NSCLC新辅助化疗免疫治疗的安全性和有效性,反映了临床试验结果.
- 观察到的化学免疫治疗的降级效果和安全性概况在一般NSCLC患者群体中可重现.
- 在现实环境中对外科手术期间的化疗免疫治疗进行进一步的研究是有必要的.
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