在直肠癌中重新考虑观察和等待策略的终点
Bartłomiej Skrzypiec1, Agnieszka Żółciak-Siwińska1, Lucyna Pietrzak1
1Department of Radiotherapy I, M. Skłodowska-Curie National Research Institute of Oncology, Warsaw, Poland.
Cancer treatment reviews
|January 7, 2026
概括
标准化观察和等待策略的终点对于比较治疗益处和风险至关重要. 目前评估临床完整反应 (cCR) 和再生率的方法需要改进,以准确反映患者的结果和推迟手术的真实风险.
科学领域:
- 在瘤学瘤学.
- 临床试验方法论 临床试验方法论
- 手术瘤学手术瘤学
背景情况:
- 观察和等待策略需要标准化的终点来进行跨试验的益处风险比较.
- 准确评估治疗的益处和主要风险 (再生) 是必不可少的.
研究的目的:
- 批判性地分析现有的终点来评估观察和等待策略.
- 为未来的研究和临床实践确定和提出标准化的终点.
主要方法:
- 进行了文献搜索,以确定和分析观察和等待策略评估中使用的终点.
- 批判性地评估常用的利益和风险评估方法的适用性.
主要成果:
- 在九项研究中确定了四个益处终点和四种复发率计算方法,突出了缺乏标准化.
- 像临床完整响应 (cCR) 率和器官保存率这样的常见终点具有局限性.
- 当前的复发率计算可能低估了风险,因为它排除了某些患者群体.
结论:
- 拟议的标准化终点:放射化疗后持续的cCR率和包括所有相关患者群体在内的再生率计算.
- 标准化是必要的,以使可靠的交叉试验对观察和等待策略进行比较.
- 精确的终点将改善对直肠癌管理中的益处风险概况的准确评估.
相关概念视频
Mouse Models of Cancer Study
Mice have long served as models for studying human biology and pathology because of their phylogenetic and physiological similarity with humans. They are also easy to maintain and breed in the laboratory, and hence, many inbred strains are now available for research. Studies on mice have contributed immeasurably to our understanding of cancer biology.
The development of transgenic, knockout, and knock-in mice has led to an exponential increase in their use as model organisms in research,...
The development of transgenic, knockout, and knock-in mice has led to an exponential increase in their use as model organisms in research,...
Targeted Cancer Therapies
The targeted cancer therapies, also known as “molecular targeted therapies,” take advantage of the molecular and genetic differences between the cancer cells and the normal cells. It needs a thorough understanding of the cancer cells to develop drugs that can target specific molecular aspects that drive the growth, progression, and spread of cancer cells without affecting the growth and survival of other normal cells in the body.
There are several types of targeted therapies against specific...
There are several types of targeted therapies against specific...
Treatment Resistant Cancers
Cancer is the second leading cause of death in the United States. A cancer cell is genetically unstable and hence can mutate faster. They can also modify their microenvironment and escape immune surveillance. The difficulties in treating cancer are further compounded by the emergence of rapid resistance to anticancer drugs. The most common ways to attain resistance in cancer cells include alteration in drug transport and metabolism, modification of drug target, elevated DNA damage response, or...
Targeted Cancer Therapies
The targeted cancer therapies, also known as “molecular targeted therapies,” take advantage of the molecular and genetic differences between the cancer cells and the normal cells. It needs a thorough understanding of the cancer cells to develop drugs that can target specific molecular aspects that drive the growth, progression, and spread of cancer cells without affecting the growth and survival of other normal cells in the body.
There are several types of targeted therapies against specific...
There are several types of targeted therapies against specific...
Treatment Resistent Cancers
Cancer is the second leading cause of death in the United States. A cancer cell is genetically unstable and hence can mutate faster. They can also modify their microenvironment and escape immune surveillance. The difficulties in treating cancer are further compounded by the emergence of rapid resistance to anticancer drugs. The most common ways to attain resistance in cancer cells include alteration in drug transport and metabolism, modification of drug target, elevated DNA damage response, or...
Cancer Survival Analysis
Cancer survival analysis focuses on quantifying and interpreting the time from a key starting point, such as diagnosis or the initiation of treatment, to a specific endpoint, such as remission or death. This analysis provides critical insights into treatment effectiveness and factors that influence patient outcomes, helping to shape clinical decisions and guide prognostic evaluations. A cornerstone of oncology research, survival analysis tackles the challenges of skewed, non-normally...


