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转化治疗不可切除胃癌的疗效及影响因素分析

Analysis of the therapeutic effect and influencing factors on unresectable gastric cancer treated with conversion therapy.

作者信息

Han Saiyi, Han Shaoliang, Qian Jun, Guo Mengfu, Fan Jianping

机构信息

The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People's Hospital, Quzhou, China.

Department of The Gastrointestinal Surgery, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.

出版信息

Front Oncol. 2024 Oct 30;14:1435398. doi: 10.3389/fonc.2024.1435398. eCollection 2024.

Abstract

BACKGROUND

Gastric cancer (GC) is one of the leading causes of cancer-related death in China, and with the extensive development of conversion therapy, the treatment of advanced unresectable gastric cancer (AUGC) patients has ushered in a new dawn. This study aimed to analyze the efficacy of conversion therapy in AUGC patients and explored the relevant factors affecting the efficacy.

METHOD

We collected information from GC patients who received conversion therapy from this center and designed a retrospective study.

RESULTS

We collected relevant clinical data from 160 patients with AUGC. A total of 120 patients who underwent routine R0 resection were identified as conversion cases. A total of 25 patients (15.6%) achieved pCR, 92 patients (57.5%) achieved objective response rate (ORR), 140 patients (87.5%) achieved disease control rate (DCR), and 20 cases (12.5%) observed tumor progression. There were 86 patients who achieved pathological downgrading, with a total downgrading rate of 53.8%. Among the 160 patients, 37 patients (23.1%) had postoperative complications of varying degrees. A total of 72 patients (45.0%) had tumor recurrence/progression at the end of follow-up. The last chemotherapy and surgery (CST) (OR = 1.046, 95% CI 1.013-1.081, = 0.006), tumor invasion (OR = 32.096, 95% CI 5.091-202.349, < 0.001), and distant metastasis (OR = 7.050, 95% CI 1.888-26.323, = 0.004) were independent factors influencing the efficacy of conversion therapy.

CONCLUSION

Conversion therapy may have a good therapeutic efficacy for AUGC, and some clinical factors affect the efficacy response.

摘要

背景

胃癌(GC)是中国癌症相关死亡的主要原因之一,随着转化治疗的广泛开展,晚期不可切除胃癌(AUGC)患者的治疗迎来了新的曙光。本研究旨在分析转化治疗对AUGC患者的疗效,并探讨影响疗效的相关因素。

方法

我们收集了本中心接受转化治疗的GC患者的信息,并设计了一项回顾性研究。

结果

我们收集了160例AUGC患者的相关临床数据。共有120例行常规R0切除的患者被确定为转化病例。共有25例患者(15.6%)达到病理完全缓解(pCR),92例患者(57.5%)达到客观缓解率(ORR),140例患者(87.5%)达到疾病控制率(DCR),20例患者(12.5%)观察到肿瘤进展。有86例患者实现了病理降期,总降期率为53.8%。160例患者中,37例(23.1%)出现不同程度的术后并发症。共有72例患者(45.0%)在随访结束时出现肿瘤复发/进展。末次化疗与手术间隔时间(CST)(OR = 1.046,95%CI 1.013 - 1.081,P = 0.006)、肿瘤侵犯(OR = 32.096,95%CI 5.091 - 202.349,P < 0.001)和远处转移(OR = 7.050,95%CI 1.888 -

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