在新辅助免疫化学疗法后的病理完整反应口腔癌中缓解辐射疗法:平等的生存率,更好的生活和生物标志物指南
1Department of Conservative Dentistry, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Frontiers in oncology
|February 20, 2026
概括
在新辅助免疫化学疗法 (NICT) 后获得完整反应的口腔癌患者中,省略辅助放射治疗是安全的. 使用TP53突变和B细胞特征的生物标志物模型可以个性化这种降级策略.
科学领域:
- 在瘤学瘤学.
- 免疫治疗是一种免疫疗法.
- 辐射疗法 辐射疗法
背景情况:
- 局部发达的口腔状细胞癌 (OSCC) 治疗通常涉及辅助放射治疗.
- 在新辅助免疫化学疗法 (NICT) 后实现病理完整反应 (pCR) 的患者中,放射治疗缺失的作用尚不清楚.
研究的目的:
- 评估OSCC患者在NICT后的PCR下降辐射疗法的瘤安全性.
- 确定预测这种降级战略成功的生物标志物.
主要方法:
- 追溯队列研究,比较放射治疗降级组 (n=65) 与标准护理组 (n=286).
- 倾向性得分匹配 (PSM) 用于比较无疾病生存率 (DFS).
- 治疗前活检的基因组和免疫分析,以找到复发预测因素.
主要成果:
- 在降级和标准护理组之间,PSM显示了相当的DFS (p=0.425).
- 降级改善了生活质量,降低了辐射毒性,增加了与免疫相关的不良事件.
- 在降级队列中,TP53突变和低B细胞特征独立预测了更糟糕的DFS.
- 一个由两种生物标志物组成的模型将患者分为不同的复发风险组 (p=0.019).
结论:
- 与维持免疫治疗一起放弃放射治疗是OSCC患者在NICT后pCR的安全,有益的策略.
- 一个集成的TP53/B细胞生物标志物模型显示了个性化放射治疗降级的潜力.
相关概念视频
02:49Cancer Therapies
8.5K
Cancer therapies are various modes of treatment, such as surgery, radiation therapy, and chemotherapy that are administered to cancer patients.
However, cancer treatments can pose several challenges, as therapies used to kill cancer cells are generally also toxic to normal cells. Moreover, cancer cells mutate rapidly and can develop resistance to chemical agents or radiation therapy. Besides, all types of cancer cells may not respond to the same therapy. Some cancer cells respond to one...
However, cancer treatments can pose several challenges, as therapies used to kill cancer cells are generally also toxic to normal cells. Moreover, cancer cells mutate rapidly and can develop resistance to chemical agents or radiation therapy. Besides, all types of cancer cells may not respond to the same therapy. Some cancer cells respond to one...
8.5K
02:56Treatment Resistant Cancers
2.6K
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...
2.6K