胆道癌根治术后辅助化疗与化疗免疫治疗的回顾性研究。

IF 4.8 2区 医学 Q1 ONCOLOGY
Oncologist Pub Date : 2025-06-04 DOI:10.1093/oncolo/oyaf163
Yuhuai Peng, Guoyi Xia, Yufeng Li, Jia Zhou, Sulai Liu, Chuang Peng, Yuewei Tao, Ou Li, Yinghui Song
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引用次数: 0

摘要

背景与目的:胆道癌根治性切除后的预后仍不理想。然而,辅助治疗的临床价值仍存在争议。本回顾性研究旨在评价BTC根治后辅助化疗和辅助化疗免疫治疗的临床价值。方法:回顾性收集2020年1月至2024年7月湖南省人民医院行根治性手术的BTC患者资料。根据患者术后接受的治疗情况将患者分为观察组、辅助化疗组和辅助化疗免疫治疗组。生存曲线采用Kaplan-Meier法测定。采用COX比例风险回归模型确定独立预后危险因素。辅助化疗组与辅助化疗免疫治疗组采用倾向评分1:1匹配分析。结果:219例BTC患者再次入组,其中iCCA 108例,pCCA 39例,DCCA 15例,GBC 57例。单纯手术87例(39.73%),术后辅助化疗69例(31.51%),术后辅助化疗免疫治疗63例(28.77%)。三组患者的中位无复发生存期(RFS)(13.20个月vs 20.40个月vs 19.68个月)差异无统计学意义(P =0.195)。化疗免疫治疗组的中位总生存期(OS)最长(29.20个月vs 31.5个月vs 43.27个月)(P=0.003)。PSM后,两辅助组的中位RFS(22.03个月vs 19.87个月)无差异(P =0.350)。化疗免疫治疗组的中位生存期更长(45.27个月vs 29.40个月)(P =0.015)。在Cox分析中,淋巴结转移、分化和辅助治疗是BTC患者OS的独立预测因子。最常见的不良事件是任何级别的血液毒性。两组均未发生与药物相关的死亡。结论:化疗免疫治疗的安全性是可接受的,可显著延长BTC的总生存期。这些数据为另一项前瞻性临床试验提供了基础,以评估化疗免疫治疗在BTC辅助治疗中的疗效。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Postoperative adjuvant chemotherapy and chemoimmunotherapy after radical resection for biliary tract cancer: a retrospective study.

Background and objectives: The prognosis of biliary tract cancers (BTC) after radical resection is still unsatisfactory. However, the clinical value of adjuvant therapy remains controversial. This retrospective study aimed to evaluate the clinical value of adjuvant chemotherapy and adjuvant chemoimmunotherapy in patients with BTC after radical resection.

Methods: Data from BTC patients who underwent radical resection were retrospectively obtained from Hunan Provincial People's Hospital between January 2020 and July 2024. Patients were divided into observation group, adjuvant chemotherapy group, and adjuvant chemoimmunotherapy group according to the treatment received by the patient after surgery. Survival curves were determined by the Kaplan-Meier method. The COX proportional hazards regression model was used to determine independent prognostic risk factors. The adjuvant chemotherapy group and adjuvant chemoimmunotherapy group were analyzed by PSM at a 1:1 ratio.

Results: A total of 219 patients with BTC were reenrolled in this study, with 108 cases of iCCA, 39 cases of pCCA, 15 cases of DCCA, and 57 cases of GBC. Eighty-seven patients (39.73%) received surgery alone, 69 patients (31.51%) received postoperative adjuvant chemotherapy, and 63 patients (28.77%) received postoperative adjuvant chemoimmunotherapy. There was no different significance for median recurrence-free survival (RFS) in the 3 groups (13.20 vs 20.40 vs 19.68 months; P = .195). The median overall survival (OS) was the longest in the chemoimmunotherapy group (29.20 vs 31.5 vs 43.27 months; P = .003). After propensity score matching (PSM), there was no difference in median RFS in the 2 adjuvant groups (22.03 vs 19.87 months; P = .350). The median OS was longer in the chemoimmunotherapy group (45.27 vs 29.40 months; P = .015). In Cox analysis, lymph node metastasis, differentiation, and adjuvant treatment were the independent predictors of OS in patients with BTC. The most common adverse events were of any grade of hematologic toxicity. No drug-related deaths occurred in either group.

Conclusions: The safety of chemoimmunotherapy was acceptable and could significantly prolong the overall survival of BTC. These data provided a basis for an additional prospective clinical trial to evaluate the efficacy of chemoimmunotherapy in adjuvant therapy for BTC.

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来源期刊
Oncologist
Oncologist 医学-肿瘤学
CiteScore
10.40
自引率
3.40%
发文量
309
审稿时长
3-8 weeks
期刊介绍: The Oncologist® is dedicated to translating the latest research developments into the best multidimensional care for cancer patients. Thus, The Oncologist is committed to helping physicians excel in this ever-expanding environment through the publication of timely reviews, original studies, and commentaries on important developments. We believe that the practice of oncology requires both an understanding of a range of disciplines encompassing basic science related to cancer, translational research, and clinical practice, but also the socioeconomic and psychosocial factors that determine access to care and quality of life and function following cancer treatment.
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