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新辅助放疗与辅助放疗用于可切除的局部晚期胃癌：一项监测、流行病学和最终结果（SEER）人群分析

Neoadjuvant versus adjuvant radiotherapy for resectable locally advanced gastric cancer: A SEER population analysis.

作者信息

Yang Guangrong, Yang Qiao, Cui Lin, Dong Qiang, Meng Zhu, Yang Changqing, Sun Jianguo

机构信息

Department of Oncology, The People's Hospital of Qijiang District, Chongqing 401420, China.

Department of Ultrasound, The 941th Hospital of the PLA Joint Logistic Support Force, Xining 810007, China.

出版信息

Heliyon. 2024 Jan 29;10(3):e25461. doi: 10.1016/j.heliyon.2024.e25461. eCollection 2024 Feb 15.

DOI:10.1016/j.heliyon.2024.e25461
PMID:38356572
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10864974/
Abstract

BACKGROUND

There is a lack of evidence on whether resectable locally advanced gastric cancer (LAGC) patients could benefit from neoadjuvant or adjuvant radiotherapy (RT).

METHODS

Patients with surgically diagnosed LAGC from 2004 to 2015 were retrieved from the SEER database. Kaplan-Meier method and the log-rank test were used to evaluate survival analysis between neoadjuvant and adjuvant RT. Univariate Cox regression was used to evaluate the hazard ratio (HR) and 95 % confidence interval (CI).

RESULTS

A total of 4790 LAGC patients who treated with surgery and RT were identified, including 3187 patients with intestinal subtype and 1603 patients with diffuse subtype. For patients with both intestinal and diffuse subtypes, median cancer-specific survival (mCSS) was better with adjuvant RT or neoadjuvant RT. Moreover, patients benefited more from adjuvant RT than neoadjuvant RT (intestinal subtype: mCSS 49 vs. 36 months, ; diffuse subtype: mCSS 32 vs. 26 months, ). Further analyses showed that patients with intestinal subtype and TN, TN, TN subgroups, as well as patients with diffuse subtype and TN and TN subgroups benefited more from adjuvant RT than those with neoadjuvant RT. Patients in the diffuse subtype and TN subgroups also tended benifit from adjuvant RT and survive. There was no difference in survival between the TN and TN  subgroups of the two subtypes. After propensity score matching, subgroup analysis identified an improved survival in favor of adjuvant RT in the age ≥65 years and female subgroups in diffuse subtypes and TN patients.

CONCLUSIONS

For patients with resectable LAGC in the TN, TN, TN clinical subgroups, adjuvant RT yields more benefits than neoadjuvant RT or no RT, which is worthy of prospective clinical trial.

摘要

背景

关于可切除的局部晚期胃癌（LAGC）患者是否能从新辅助或辅助放疗（RT）中获益，目前缺乏证据。

方法

从监测、流行病学与最终结果（SEER）数据库中检索2004年至2015年经手术诊断为LAGC的患者。采用Kaplan-Meier法和对数秩检验评估新辅助放疗和辅助放疗之间的生存分析。单因素Cox回归用于评估风险比（HR）和95%置信区间（CI）。

结果

共确定了4790例接受手术和放疗的LAGC患者，其中包括3187例肠型亚型患者和1603例弥漫型亚型患者。对于肠型和弥漫型亚型患者，辅助放疗或新辅助放疗的中位癌症特异性生存期（mCSS）更好。此外，患者从辅助放疗中获益比新辅助放疗更多（肠型亚型：mCSS为49个月对36个月；弥漫型亚型：mCSS为32个月对26个月）。进一步分析表明，肠型亚型以及TN、TN、TN亚组的患者，以及弥漫型亚型和TN及TN亚组的患者从辅助放疗中获益比新辅助放疗更多。弥漫型亚型和TN亚组的患者也倾向于从辅助放疗中获益并存活。两种亚型的TN和TN亚组之间的生存率没有差异。在倾向评分匹配后，亚组分析发现，在年龄≥６５岁的患者以及弥漫型亚型和TN患者的女性亚组中，辅助放疗有利于提高生存率。

结论

对于TN、TN、TN临床亚组中可切除的LAGC患者，辅助放疗比新辅助放疗或不放疗产生更多益处，这值得进行前瞻性临床试验。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5e05/10864974/6c87fc5d5b52/mmcfigs7.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5e05/10864974/42f02f39549c/mmcfigs1.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5e05/10864974/1ff180729b5d/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5e05/10864974/a874dc1c021c/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5e05/10864974/819290e98efa/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5e05/10864974/9aa131655fee/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5e05/10864974/5b7408347237/gr5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5e05/10864974/79da580c9b00/gr6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5e05/10864974/1fcd969767b9/gr7.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5e05/10864974/42f02f39549c/mmcfigs1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5e05/10864974/3b4f384c63ab/mmcfigs2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5e05/10864974/30f8e4d300cc/mmcfigs3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5e05/10864974/3c3a5c20bf1c/mmcfigs4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5e05/10864974/6dd88653e15e/mmcfigs5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5e05/10864974/605fcbd70ff1/mmcfigs6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5e05/10864974/6c87fc5d5b52/mmcfigs7.jpg

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本文引用的文献

1
Gastric cancer: ESMO Clinical Practice Guideline for diagnosis, treatment and follow-up.胃癌：ESMO 诊断、治疗及随访临床实践指南
Ann Oncol. 2022 Oct;33(10):1005-1020. doi: 10.1016/j.annonc.2022.07.004. Epub 2022 Jul 29.
2
Clinical Significance of Preoperative Hematological Parameters in Patients with D2-Resected, Node-Positive Stomach Cancer.D2根治性切除的淋巴结阳性胃癌患者术前血液学参数的临床意义
Biomedicines. 2022 Jun 30;10(7):1565. doi: 10.3390/biomedicines10071565.
3
Preoperative versus postoperative chemo-radiotherapy for locally advanced gastric cancer: a multicenter propensity score-matched analysis.
术前与术后放化疗治疗局部进展期胃癌：多中心倾向评分匹配分析。
BMC Cancer. 2022 Feb 26;22(1):212. doi: 10.1186/s12885-022-09297-7.
4
Gastric Cancer, Version 2.2022, NCCN Clinical Practice Guidelines in Oncology.《胃癌，第2.2022版，美国国立综合癌症网络（NCCN）肿瘤学临床实践指南》
J Natl Compr Canc Netw. 2022 Feb;20(2):167-192. doi: 10.6004/jnccn.2022.0008.
5
Proteomic Signatures of Diffuse and Intestinal Subtypes of Gastric Cancer.胃癌弥漫型和肠型亚型的蛋白质组学特征
Cancers (Basel). 2021 Nov 25;13(23):5930. doi: 10.3390/cancers13235930.
6
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BMC Cancer. 2021 Jul 3;21(1):771. doi: 10.1186/s12885-021-08534-9.
7
First-line nivolumab plus chemotherapy versus chemotherapy alone for advanced gastric, gastro-oesophageal junction, and oesophageal adenocarcinoma (CheckMate 649): a randomised, open-label, phase 3 trial.一线纳武利尤单抗联合化疗与单纯化疗治疗晚期胃癌、胃食管交界癌和食管腺癌（CheckMate 649）：一项随机、开放标签的3期试验。
Lancet. 2021 Jul 3;398(10294):27-40. doi: 10.1016/S0140-6736(21)00797-2. Epub 2021 Jun 5.
8
Role of Radiation Therapy in Gastric Cancer.放疗在胃癌中的作用。
Ann Surg Oncol. 2021 Aug;28(8):4151-4157. doi: 10.1245/s10434-021-09639-y. Epub 2021 Mar 10.
9
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CA Cancer J Clin. 2021 May;71(3):264-279. doi: 10.3322/caac.21657. Epub 2021 Feb 16.
10
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Ann Oncol. 2021 Mar;32(3):368-374. doi: 10.1016/j.annonc.2020.11.017. Epub 2020 Dec 3.