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化学辐射疗法与或没有同时免疫检查点抑制剂用于局部晚期食道状细胞癌:一个多中心的回顾性研究
Jiang-Qiong Huang1, Hui-Min Xiao2, Cheng-Xian Ma1
1Department of Radiation Oncology, Guangxi Medical University Cancer Hospital, Nanning, Guangxi, P.R. China.
概括
与免疫检查点抑制剂同时进行化学放射治疗并没有改善食道癌的存活率. 然而,化学放射治疗后的顺序免疫疗法显示出无疾病生存的前景,强调了时间的重要性.
科学领域:
- 在瘤学瘤学.
- 免疫治疗是一种免疫疗法.
- 胃肠道癌症 胃肠道癌症是什么?
背景情况:
- 局部发达的食道状细胞癌 (ESCC) 治疗通常涉及并发化学放射治疗 (CCRT).
- 免疫检查点抑制剂 (ICI) 在癌症治疗中的整合已经显示出希望,但其在ESCC的最佳时间尚不清楚.
研究的目的:
- 为了比较CCRT和CCRT与局部发达ESCC患者的同时ICI之间的生存结果和安全性.
- 调查ICI时间对ESCC治疗疗效的影响.
主要方法:
- 在2010年1月至2024年4月期间对290名局部发达ESCC患者进行的多中心队列研究.
- 患者被分为两组:单独使用CCRT (n=226) 和CCRT与并发ICI (CCRT+ICI) (n=64).
- 分析了生存结果 (总生存率,无病生存率) 和安全性 (不良事件,淋巴细胞和单细胞计数).
主要成果:
- 与单独使用CCRT相比,CCRT+ICI没有改善整体存活率或无病存活率.
- 与CCRT+ICI相比,CCRT之后的ICI维持疗法显示了较好的无病存活率.
- CCRT+ICI与3级以上白血病和中性病的发病率较高有关. 淋巴细胞数量下降,而单细胞数量在治疗后的CCRT+ICI组增加.
结论:
- 与CCRT同时进行ICI并没有提高局部发达ESCC的存活率,可能是由于CCRT诱导的免疫抑制.
- ICI整合的时间是至关重要的,因为CCRT之后的ICI维持疗法证明了无病生存率的改善.
- 需要进一步的研究来优化ESCC的免疫疗法策略.
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