更多是更好的吗? 评估高风险上道尿路癌的手术前的新辅助化疗周期
Taibo Li1, Stephan Brönimann2, Joseph Cheaib1
1James Buchanan Brady Urological Institute, Johns Hopkins University School of Medicine, Baltimore, MD.
Urologic oncology
|March 1, 2026
概括
对于上道泌尿道癌 (UTUC),三到四次的新辅助化疗 (NAC) 显示了类似的病理反应率. 与高风险UTUC患者的3个周期相比,四个周期的NAC可以改善整体存活率.
科学领域:
- 尿癌研究 尿癌研究
- 新辅助化疗疗法的有效性
- 瘤结局分析结果分析
背景情况:
- 新辅助化疗 (NAC) 越来越多地支持上道泌尿道癌 (UTUC).
- 高风险UTUC的最佳NAC循环计数仍未确定.
- 这项研究评估了NAC周期对病理反应和生存的影响.
研究的目的:
- 为了确定上道泌尿道癌的新辅助化疗周期的最佳数量.
- 评估不同的NAC周期对病理反应和生存结果的影响.
- 为了在高风险的UTUC中比较3和4周期的基于西斯的NAC之间的结果.
主要方法:
- 来自UCAN数据库的187名高风险,临床结节阴性UTUC患者的回顾性分析.
- 患者在进行激进瘤切除术 (RNU) 之前接受了1-4个基于西斯的NAC循环.
- 终点包括病理完整反应 (pCR),无膀癌生存率 (BCFS),无转移生存率 (MFS),癌症特异性生存率 (CSS) 和整体生存率 (OS).
主要成果:
- 在1-2个NAC周期中没有观察到PCR;在3-4个周期中,PCR为14%.
- 在3个 (11%) 和4个 (15%) 周期 (P=0.49) 之间具有相似的pCR率.
- 与三个周期 (P=0.003) 相比,四个NAC周期显著改善了整体存活率 (OS),但不是MFS,BCFS或CSS.
结论:
- 病理完整反应和癌症特异性结局在高风险UTUC的3到4个NAC周期之间是可比的.
- 四个周期的NAC可以在三个周期中提供整体生存益处.
- 需要进行前性验证,以优化高风险UTUC的NAC疗法,平衡疗效和毒性.
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