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一项针对大小≤2 cm且实性肿瘤比例在0.25至0.5之间的浸润性磨玻璃影型肺癌进行楔形切除术的单臂、多中心、前瞻性、确证性III期试验方案(ECTOP - 1020研究)

Protocol for a single-arm, multicenter, prospective, confirmatory phase III trial of wedge resection for invasive ground glass opacity-featured lung cancer with a size ≤2 cm and a consolidation tumor ratio between 0.25 and 0.5 (ECTOP-1020 study).

作者信息

Li Tong, Fu Fangqiu, Zhang Yang, Chen Haiquan

机构信息

Department of Thoracic Surgery and State Key Laboratory of Genetic Engineering, Fudan University Shanghai Cancer Center, Shanghai, China.

Institute of Thoracic Oncology, Fudan University, Shanghai, China.

出版信息

J Thorac Dis. 2024 Jul 30;16(7):4711-4718. doi: 10.21037/jtd-24-440. Epub 2024 Jul 9.

DOI:10.21037/jtd-24-440
PMID:39144343
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11320279/
Abstract

BACKGROUND

Segmentectomy is the current standard treatment for ground glass opacity (GGO)-featured lung cancer patients with a tumor size ≤2 cm and a consolidation tumor ratio (CTR) between 0.25 and 0.5. However, compared with wedge resection, segmentectomy destroys the patient's hilar structure and consumes more lung parenchyma. A recent study demonstrated that wedge resection could yield comparable results for this group of patients.

METHODS

This study aimed to confirm the noninferiority of wedge resection over standard surgery in invasive GGO-featured lung cancer patients with a size ≤2 cm and a CTR between 0.25 and 0.5, as measured by 5-year overall survival (OS). The primary endpoint is 5-year OS. The secondary endpoints are 5-year recurrence-free survival (RFS), the R0 resection rate, pulmonary function, recurrence and metastasis sites, and adverse events after surgery. During the trial period, 286 patients are enrolled from six Chinese institutions.

DISCUSSION

The primary results of this study will be actively disseminated through manuscript publications and conference presentations. This prospective study will evaluate the surgical efficacy and safety of wedge resection for small (tumor size ≤2 cm with a CTR between 0.25 and 0.5) invasive GGO-featured lung cancer and will support the standardization of this surgical strategy.

TRIAL REGISTRATION

This trial has been registered on ClinicalTrial.gov (No. NCT06102161).

摘要

背景

对于肿瘤大小≤2 cm且实性肿瘤比例(CTR)在0.25至0.5之间的磨玻璃影(GGO)型肺癌患者,肺段切除术是目前的标准治疗方法。然而,与楔形切除术相比,肺段切除术会破坏患者的肺门结构,消耗更多的肺实质。最近一项研究表明,楔形切除术对这组患者可产生相似的结果。

方法

本研究旨在通过5年总生存期(OS)来证实楔形切除术相对于标准手术治疗肿瘤大小≤2 cm且CTR在0.25至0.5之间的浸润性GGO型肺癌患者的非劣效性。主要终点是5年OS。次要终点包括5年无复发生存期(RFS)、R0切除率、肺功能、复发和转移部位以及术后不良事件。在试验期间,从中国六家机构招募了286例患者。

讨论

本研究的主要结果将通过发表论文和在会议上报告的方式积极传播。这项前瞻性研究将评估楔形切除术治疗小(肿瘤大小≤2 cm且CTR在0.25至0.5之间)浸润性GGO型肺癌的手术疗效和安全性,并将支持这种手术策略的标准化。

试验注册

本试验已在ClinicalTrial.gov上注册(编号:NCT06102161)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c378/11320279/e86e2b6fbe07/jtd-16-07-4711-f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c378/11320279/e86e2b6fbe07/jtd-16-07-4711-f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c378/11320279/e86e2b6fbe07/jtd-16-07-4711-f1.jpg

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J Thorac Cardiovasc Surg. 2024 Mar;167(3):797-809.e2. doi: 10.1016/j.jtcvs.2023.06.010. Epub 2023 Jun 27.
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