胸腔食管鳞状细胞癌的新辅助化放疗:每个人都需要吗?

Q4 Medicine
D. A. Chichevatov, E. Sinev, A. Glukhov, O. M. Seliverstova
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引用次数: 0

摘要

目的。根据临床指南,新辅助化放疗(nCRT)被推荐为治疗胸腔食管鳞状细胞癌(TESCC)的有利选择。然而,一些研究并未证明 nCRT 的潜在益处。在本文中,我们比较了单纯手术与术前 CRT 再手术的治疗效果。材料与方法第1组(n=147)由单独接受手术的患者组成。第 2 组(n=3337)是在本系统综述和荟萃分析(15 篇文献共收集了 20 个不同的亚组进行分析)的框架下成立的。第 2 组患者先接受 nCRT 治疗,然后进行食管切除术。对总生存期(OS)和中位OS进行了估算。结果。第1组和第2组的12个独立亚组(3337名患者中的2310名)均达到了OS中位数。在第 1 组和第 2 组中,OS 中位数分别为 31.0 和 28.1(P=0.873)。3年和5年的OS分别为0.49 vs 0.48(P=0.425)和0.37 vs 0.41(P=0.228)。第 2 组的 8 个亚组(3337 例患者中的 1027 例)未达到中位 OS。在这种情况下,第2组患者的3年和5年OS明显高于第1组患者:分别为 0.69 vs 0.49(P=0.000)和 0.60 vs 0.37(P=0.000)。结论:nCRT 并不适合所有 TESCC 患者。对新辅助治疗病理肿瘤反应分级高的患者,总生存率可能会有所提高。根据对肿瘤完全反应的高度预测,有选择地进行 nCRT 似乎很有希望。这一概念还需要进一步研究。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Neoadjuvant chemoradiotherapy for thoracic esophageal squamous cell carcinoma: does everyone need it?
Objective. In accordance with clinical guidelines, neoadjuvant chemoradiotherapy (nCRT) is recommended as a beneficial option for treatment of thoracic esophageal squamous cell carcinoma (TESCC). However, some studies did not demonstrate potential benefits of nCRT. In this paper we compared treatment outcomes of surgery alone with preoperative CRT followed by surgery. Material and methods. Group 1 (n=147) consisted of patients who underwent surgery alone. Group 2 (n=3,337) was formed in the framework of the present systematic review and meta-analysis (15 publications captured 20 separate subgroups for analysis). Patients of group 2 received nCRT followed by esophagectomy. Overall survival (OS) and median OS were estimated. Results. The median OS was reached in group 1 and in 12 separate subgroups of group 2 (2310 of 3337 patients). In groups 1 and 2 the OS median estimates were 31.0 and 28.1, respectively (p=0.873). Respective 3-year and 5-year OS were 0.49 vs 0.48 (p=0.425) and 0.37 vs 0.41 (p=0.228). The median OS was not reached in 8 separate subgroups of group 2 (1027 of 3337 patients). In this case, group 2 patients had significantly higher 3- and 5-year OS compared to group 1 patients: 0.69 vs 0.49 (p=0.000) and 0.60 vs 0.37 (p=0.000), respectively. Pathological complete response to nCRT was associated with better survival. conclusion. nCRT is not appropriate for all patients with TESCC. Improved overall survival may be achieved in patients with a high grade of pathological tumor response to neoadjuvant treatment. Selective administration of nCRT based on highly probable prediction of complete tumor response seems promising. This concept needs further research.
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来源期刊
Siberian journal of oncology
Siberian journal of oncology Medicine-Oncology
CiteScore
0.40
自引率
0.00%
发文量
117
审稿时长
8 weeks
期刊介绍: The main objectives of the journal are: -to promote the establishment of Russia’s leading worldwide positions in the field of experimental and clinical oncology- to create the international discussion platform intended to cover all aspects of basic and clinical cancer research, including carcinogenesis, molecular biology, epidemiology, cancer prevention, diagnosis and multimodality treatment (surgery, chemotherapy, radiation therapy, hormone therapy), anesthetic management, medical and social rehabilitation, palliative care as well as the improvement of life quality of cancer patients- to encourage promising young scientists to be actively involved in cancer research programs- to provide a platform for researches and doctors all over the world to promote, share, and discuss various new issues and developments in cancer related problems. (to create a communication platform for the expansion of cooperation between Russian and foreign professional associations).- to provide the information about the latest worldwide achievements in different fields of oncology The most important tasks of the journal are: -to encourage scientists to publish their research results- to offer a forum for active discussion on topics of major interest - to invite the most prominent Russian and foreign authors to share their latest research findings with cancer research community- to promote the exchange of research information, clinical experience, current trends and the recent developments in the field of oncology as well as to review interesting cases encountered by colleagues all over the world- to expand the editorial board and reviewers with the involvement of well-known Russian and foreign experts- to provide open access to full text articles- to include the journal into the international database- to increase the journal’s impact factor- to promote the journal to the International and Russian markets
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