Current status of neoadjuvant therapy for locally advanced rectal cancer in Wuhan Union Hospital Cancer Center.
Current status of neoadjuvant therapy for locally advanced rectal cancer in Wuhan Union Hospital Cancer Center.
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武汉协和医院肿瘤中心局部晚期直肠癌新辅助治疗现状
DOI：
10.1186/s13014-022-02081-8
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发表时间：
2022-06-20
影响因子：
3.6
通讯作者：
Zhang, Tao
中科院分区：
文献类型：
--
作者：
Zhai, Meng-Lan;Zhang, Fang-Yuan;Yang, Jin-Ru;Zhang, Sheng;Zhao, Lei;Lin, Zhen-Yu;Wang, Jing;Yu, Dan-Dan;Zhang, Tao
关键词：
分析和探讨武汉协和医院肿瘤中心中低LARC患者新辅助治疗的进展和近期疗效。收集了2015年1月至2021年12月诊断为直肠癌的患者。分析接受新辅助治疗的中低LARC患者的治疗模式、近期疗效和治疗相关不良事件（AE）。采用卡方检验比较组间差异。共入组980例中低LARC患者，随着时间的推移，接受新辅助治疗的患者比例逐渐增加，确诊后直接手术的治疗模式逐渐淡化。80%以上的患者实施了以放疗为主的新辅助治疗，2020年后SCRT序贯全身治疗的患者比例逐渐超过LCRT联合化疗。在所有完成放疗并接受手术的患者中，170例患者接受长疗程放化疗（LCRT）联合化疗（C组），98例患者接受短程放疗（SCRT）联合全身治疗（化疗联合或不联合免疫治疗）（D组）。D组病理完全缓解率（pCR）明显高于C组（38.8%比19.4%，P = 0.001）。SCRT+免疫治疗组pCR率为49.2%，明显高于未免疫治疗组的21.6%（P = 0.007）。82.3%接受免疫治疗的患者接受SCRT序贯2周期CapOX加Camrelizumab治疗，pCR高达52.9%。免疫治疗未增加3-4级AE的发生率。以放疗为基础的新辅助治疗逐渐用于中低LARC患者。SCRT序贯全身治疗在我们中心的LARC患者中越来越广泛地使用。与传统的LCRT或SCRT序贯化疗相比，SCRT序贯化疗联合免疫治疗具有显著的pCR率和可控制的毒性。期待这种新的治疗模式将为患者带来持久的生存益处。在线版本包含补充材料，可通过10.1186/s13014-022-02081-8获得。
To analyze and explore the evolution and short-term efficacy of neoadjuvant therapy for patients with mid and low LARC in Wuhan Union Hospital Cancer Center. Patients diagnosed with rectal cancer from January 2015 to December 2021 were collected. The treatment patterns, short-term efficacy and treatment-related adverse events (AEs) of mid and low LARC patients who received neoadjuvant therapy were analyzed. The Chi-square test was used to compare the differences between groups. A total of 980 patients with mid and low LARC were enrolled, over time, the proportion of patients receiving neoadjuvant therapy gradually increased, and the treatment mode of direct surgery after diagnosis was gradually watered down. More than 80% of the patients implemented radiotherapy-based neoadjuvant therapy, and the proportion of patients receiving SCRT sequential systemic therapy gradually exceeded that of LCRT combined chemotherapy after 2020. Of all patients who completed radiotherapy and underwent surgery, 170 patients received long-course chemoradiotherapy (LCRT) combined with chemotherapy (Group C) and 98 patients received short-course radiotherapy (SCRT) combined with systemic therapy (chemotherapy with or without immunotherapy) (Group D). The pathological complete response (pCR) rate in Group D was significantly higher than that in Group C (38.8% vs. 19.4%, P = 0.001). The pCR rate in the SCRT plus immunotherapy group was better than that in the group without immunotherapy (49.2% vs. 21.6%, P = 0.007). 82.3% of the patients receiving immunotherapy were treated with SCRT sequential 2-cycle CapOX plus Camrelizumab treatment, and the pCR was as high as 52.9%. Immunotherapy did not increase the incidence of Grade 3–4 AEs. Neoadjuvant therapy based on radiotherapy is becoming used in patients with mid and low LARC. SCRT sequential systemic therapy is increasingly widely used in LARC patients in our center. Compared with the traditional LCRT or SCRT sequential chemotherapy, SCRT sequential chemotherapy plus immunotherapy has a remarkable pCR rate and manageable toxicity. Looking forward this new treatment mode will bring lasting survival benefits to patients. The online version contains supplementary material available at 10.1186/s13014-022-02081-8.
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DOI：
10.6004/jnccn.2018.0061
发表时间：
2018-07
期刊：
Journal of the National Comprehensive Cancer Network : JNCCN
影响因子：
--
作者：
Benson AB;Venook AP;Al-Hawary MM;Cederquist L;Chen YJ;Ciombor KK;Cohen S;Cooper HS;Deming D;Engstrom PF;Grem JL;Grothey A;Hochster HS;Hoffe S;Hunt S;Kamel A;Kirilcuk N;Krishnamurthi S;Messersmith WA;Meyerhardt J;Mulcahy MF;Murphy JD;Nurkin S;Saltz L;Sharma S;Shibata D;Skibber JM;Sofocleous CT;Stoffel EM;Stotsky-Himelfarb E;Willett CG;Wuthrick E;Gregory KM;Gurski L;Freedman-Cass DA
通讯作者：
Freedman-Cass DA
影响因子：
5.1
作者：
Chen, Wan-qing;Zeng, Hong-mei;He, Jie
通讯作者：
He, Jie
II 期，局部晚期直肠癌术前短程放疗随后化疗和卡瑞利珠单抗的单臂试验
影响因子：
10.9
作者：
Lin Z;Cai M;Zhang P;Li G;Liu T;Li X;Cai K;Nie X;Wang J;Liu J;Liu H;Zhang W;Gao J;Wu C;Wang L;Fan J;Zhang L;Wang Z;Hou Z;Ma C;Yang K;Wu G;Tao K;Zhang T
通讯作者：
Zhang T
影响因子：
168.9
作者：
Quirke, Phil;Steele, Robert;Monson, John;Grieve, Robert;Khanna, Subhash;Couture, Jean;O'Callaghan, Chris;Myint, Arthur Sun;Bessell, Eric;Thompson, Lindsay C.;Parmar, Mahesh;Stephens, Richard J.;Sebag-Montefiore, David
通讯作者：
Sebag-Montefiore, David
影响因子：
50.5
作者：
Cisel, B.;Pietrzak, L.;Bujko, K.
通讯作者：
Bujko, K.