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在局部晚期胃癌的新辅助疗法后,病理反应的比较有效性和模式依赖的预后值
Yongfeng Zhu1, Zhenchong Chen1, Minju Jo1
1Department of Gastric Surgery, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong, People's Republic of China.
Cancer medicine
|February 12, 2026
概括
化疗免疫疗法 (NACIT) 改善了局部晚期胃癌 (LAGC) 的无疾病生存率. 病理反应是关键指标,但其与生存的相关性因新辅助疗法类型而异.
科学领域:
- 在瘤学瘤学.
- 胃肠病学 胃肠病学
- 临床试验 临床试验
背景情况:
- 新辅助疗法是局部晚期胃癌 (LAGC) 的标准.
- 病理反应是治疗有效性的关键替代品.
- 不同的新辅助疗法之间的病理反应和长期结果之间的相关性尚不清楚.
研究的目的:
- 评估病理反应与长期生存结果之间的相关性.
- 为了比较新辅助化疗 (NACT),化疗放射治疗 (NACRT) 和化疗免疫治疗 (NACIT) 在LAGC患者的疗效.
主要方法:
- 对256名LAGC患者 (2017-2022) 的回顾性队列研究.
- 患者接受了NACT (n=162),NACRT (n=48) 或NACIT (n=46).
- 使用Kaplan-Meier估计和Cox模型评估了病理反应,无疾病生存率 (DFS) 和整体生存率 (OS).
主要成果:
- 与NACT相比,NACIT显示了显著改善的DFS (HR=0.75,p=0.035),没有OS差异.
- NACRT改善了病理反应率,但没有产生生存益处.
- 主要病理反应 (MPR) 与NACT和NACIT组的生存率改善相关,但在NACRT组没有.
结论:
- 在LAGC患者中,NACIT与改善的DFS有关.
- NACRT可能表现为"病理与预后不匹配",病理反应不能保证生存优势.
- 这些发现挑战了病理反应作为替代终点的统一使用,强调了模式特定的解释.
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