Thoracic Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, 79 Qingchun Road, Shangcheng District, Hangzhou, 310000, China.
Zhejiang University School of Medicine, Huangzhou, China.
BMC Cancer. 2024 May 13;24(1):585. doi: 10.1186/s12885-024-12333-3.
The optimal timing for surgery following neoadjuvant immunochemotherapy for lung squamous cell carcinoma appears to be a topic of limited data. Many clinical studies lack stringent guidelines regarding this timing. The objective of this study is to explore the effect of the interval between neoadjuvant immunochemotherapy and surgery on survival outcomes in patients with lung squamous cell carcinoma.
This study conducted a retrospective analysis of patients with lung squamous cell carcinoma who underwent neoadjuvant immunochemotherapy between January 2019 and October 2022 at The First Affiliated Hospital, Zhejiang University School of Medicine. Patients were divided into two groups based on the treatment interval: ≤33 days and > 33 days. The primary observational endpoints of the study were Disease-Free Survival (DFS) and Overall Survival (OS). Secondary observational endpoints included Objective response rate (ORR), Major Pathological Response (MPR), and Pathological Complete Remission (pCR).
Using the Kaplan-Meier methods, the ≤ 33d group demonstrated a superior DFS curve compared to the > 33d group (p = 0.0015). The median DFS for the two groups was 952 days and 590 days, respectively. There was no statistical difference in the OS curves between the groups (p = 0.66), and the median OS was not reached for either group. The treatment interval did not influence the pathologic response of the tumor or lymph nodes.
The study observed that shorter treatment intervals were associated with improved DFS, without influencing OS, pathologic response, or surgical safety. Patients should avoid having a prolonged treatment interval between neoadjuvant immunochemotherapy and surgery.
新辅助免疫化疗后手术的最佳时机似乎是一个数据有限的话题。许多临床研究缺乏关于这一时机的严格指南。本研究的目的是探讨新辅助免疫化疗与手术之间的间隔时间对肺鳞癌患者生存结局的影响。
本研究对 2019 年 1 月至 2022 年 10 月在浙江大学医学院附属第一医院接受新辅助免疫化疗的肺鳞癌患者进行了回顾性分析。根据治疗间隔将患者分为两组：≤33 天和>33 天。本研究的主要观察终点是无病生存期（DFS）和总生存期（OS）。次要观察终点包括客观缓解率（ORR）、主要病理缓解（MPR）和病理完全缓解（pCR）。
Kaplan-Meier 方法显示，≤33d 组的 DFS 曲线优于>33d 组（p=0.0015）。两组的中位 DFS 分别为 952 天和 590 天。两组 OS 曲线无统计学差异（p=0.66），两组均未达到中位 OS。治疗间隔不影响肿瘤或淋巴结的病理反应。
本研究观察到较短的治疗间隔与改善的 DFS 相关，而不影响 OS、病理反应或手术安全性。患者应避免新辅助免疫化疗与手术之间的治疗间隔过长。
