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胆囊癌术后辅助放化疗的获益。

Benefit of Adjuvant Chemoradiotherapy in Resected Gallbladder Carcinoma.

机构信息

Center for Liver and Pancreatobiliary Cancer, Research Institute and Hospital, National Cancer Center, Goyang, 10408, Korea.

Center for Proton Therapy, Research Institute and Hospital, National Cancer Center, Goyang, 10408, Korea.

出版信息

Sci Rep. 2019 Aug 13;9(1):11770. doi: 10.1038/s41598-019-48099-z.

Abstract

To evaluate the benefit of adjuvant treatments, such as chemoradiotherapy (CRT) and chemotherapy (CTx), compared with no adjuvant treatment (No-AT) in resected gallbladder (GB) cancer patients, 151 patients were analyzed: 98 (64.9%) patients received adjuvant treatment with CRT (n = 59, 39.1%) or CTx (n = 39, 25.8%), and the remaining 53 (35.1%) did not (No-AT). The clinicopathological factors, patterns of failure, locoregional recurrence-free survival (LRFS), recurrence-free survival (RFS) and overall survival (OS) were compared among the three groups according to tumor stage. In patients with T2-3N0M0 stage disease, the incidences of locoregional recurrence and distant recurrence and 5-year LRFS, RFS and OS rates were not significantly different among the No-AT, CTx, and CRT groups (p > 0.05 each). In those with T2-3N1-2M0 stage disease, the incidences of locoregional recurrence (11.4%, 78.1%, and 68.4%, respectively) and distant recurrence (42.8%, 73.9% and 66.7%, respectively) in the CRT group were significantly lower than those in the No-AT and CTx groups (p < 0.05), and the CRT group had significantly higher 5-year LRFS (82,1%, 26.8%, and 19.0%), RFS (53.3%, 11.6% and 16.7%) and OS rates (64.0%, 22.7% and 4.3%) than the CTx and No-AT groups (p < 0.05 each). Therefore, adjuvant CRT may improve the LRFS and RFS and subsequently improve OS in lymph node-positive resected GB cancer.

摘要

为了评估辅助治疗(如放化疗[CRT]和化疗[CTx])与未行辅助治疗(No-AT)相比在切除的胆囊(GB)癌患者中的获益,分析了 151 例患者:98 例(64.9%)患者接受辅助治疗,包括 CRT(n=59,39.1%)或 CTx(n=39,25.8%),其余 53 例(35.1%)未接受治疗(No-AT)。根据肿瘤分期比较三组患者的临床病理因素、失败模式、局部区域无复发生存(LRFS)、无复发生存(RFS)和总生存(OS)。在 T2-3N0M0 期疾病患者中,No-AT、CTx 和 CRT 组的局部区域复发和远处复发以及 5 年 LRFS、RFS 和 OS 率无显著差异(p>0.05)。在 T2-3N1-2M0 期疾病患者中,CRT 组局部区域复发(11.4%、78.1%和 68.4%)和远处复发(42.8%、73.9%和 66.7%)的发生率显著低于 No-AT 和 CTx 组(p<0.05),CRT 组 5 年 LRFS(82.1%、26.8%和 19.0%)、RFS(53.3%、11.6%和 16.7%)和 OS 率(64.0%、22.7%和 4.3%)显著高于 CTx 和 No-AT 组(p<0.05)。因此,辅助 CRT 可能改善淋巴结阳性切除的 GB 癌患者的 LRFS 和 RFS,并随后改善 OS。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d059/6692378/5d2ac15d2e56/41598_2019_48099_Fig1_HTML.jpg

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