在新辅助疗法后直肠癌的长期复发模式:25年的真实世界数据
Pieter Maerten1, Gilles Defraene2, Albert Wolthuis3
1Department of Radiation-Oncology, University Hospitals Leuven, Leuven 3000, Belgium; Department of Oncology, Laboratory of Experimental Radiotherapy, KU Leuven, Leuven 3000, Belgium.
概括
结直肠癌的复发模式是由组织病理学特征和治疗反应预测的. 识别生物标志物可以个性化新辅助疗法,以在全新辅助疗法 (TNT) 时代获得更好的结果.
科学领域:
- 在瘤学瘤学.
- 手术瘤学手术瘤学
- 胃肠道瘤学 胃肠道瘤学
背景情况:
- 局部晚期直肠癌的治疗已经通过全新辅助疗法 (TNT) 进化.
- 对于个体患者来说,最佳治疗选择仍然具有挑战性.
- 这项研究评估了复发模式,以改善TNT时代的风险分层.
研究的目的:
- 为了评估直肠癌的复发模式.
- 为了改善患者的风险分层.
- 在TNT时代指导新辅助治疗决策.
主要方法:
- 850名直肠癌患者的前性队列研究.
- 患者在25年内接受了新辅助性放射和化疗.
- 平均随访时间为12年.
主要成果:
- 五年总生存率 (OS) 和无疾病生存率 (DFS) 分别为86.8%和75.5%.
- 19.6%的患者经历了复发,其中远程转移 (DM) 是最常见的 (18.6%).
- 糖尿病的独立预测因素包括淋巴血管侵袭,围神经侵袭,阳性环切割边缘和较高的淋巴结比率 (LN比率). 瘤直径和LN比率预测了局部区域复发 (LRR).
结论:
- 组织病理特征和瘤对新辅助疗法的反应预测了复发风险.
- 确定可靠的基线生物标志物对于个性化的新辅助治疗至关重要.
- 完善患者风险分层是TNT时代的关键.
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