Early response to neoadjuvant chemotherapy can help predict long-term survival in patients with cervical cancer.
Early response to neoadjuvant chemotherapy can help predict long-term survival in patients with cervical cancer.
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新辅助化疗的早期反应有助于预测宫颈癌患者的长期生存
DOI：
10.18632/oncotarget.11460
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发表时间：
2016-12-27
期刊：
影响因子：
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通讯作者：
Ma D
中科院分区：
文献类型：
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作者：
Li X;Huang K;Zhang Q;Shen J;Zhou H;Yang R;Wang L;Liu J;Zhang J;Sun H;Jia Y;Du X;Wang H;Deng S;Ding T;Jiang J;Lu Y;Li S;Wang S;Ma D
新辅助化疗（NACT）后临床缓解的宫颈癌患者是否具有更好的长期生存仍存在争议。本研究旨在探讨临床反应对接受 NACT 的宫颈癌患者无病生存 (DFS) 的影响。回顾性研究中总共853名患者用于评估临床反应是否是长期反应的指标，前瞻性队列研究中的493名患者用于进一步评估。通过对数秩检验、单变量和多变量 Cox 回归以及汇总分析来检测生存差异。对数秩检验显示，回顾性数据中，与无应答者相比，应答者的 DFS 显着较高（P = 0.007）。单变量 Cox 回归显示，回顾性研究中临床缓解是长期生存的指标（HR 1.83，95% CI 1.18-2.85，P = 0.007）。在多变量Cox模型中，临床反应在回顾性研究中仍被保留为独立的显着预后因素（HR 1.59，95% CI 1.01-2.50，P = 0.046）。该结果也在前瞻性数据中得到了验证，结果相似。这些发现表明临床反应可被视为 DFS 的独立预测因子。
It is still controversial whether cervical cancer patients with clinical responses after neoadjuvant chemotherapy (NACT) have a better long-term survival or not. This study was designed to investigate the effect of the clinical response on the disease-free survival (DFS) of cervical cancer patients undergoing NACT. A total of 853 patients from a retrospective study were used to evaluate whether the clinical response was an indicator for the long-term response, and 493 patients from a prospective cohort study were used for further evaluation. The survival difference was detected by log-rank test, univariate and multivariate Cox regression and a pooled analysis. The log-rank test revealed that compared with non-responders, the DFS of responders was significantly higher in the retrospective data (P = 0.007). Univariate Cox regression showed that the clinical response was an indicator of long-term survival in the retrospective study (HR 1.83, 95% CI 1.18-2.85, P = 0.007). In a multivariate Cox model, the clinical response was still retained as an independent significant prognostic factor in the retrospective study (HR 1.59, 95% CI 1.01-2.50, P = 0.046). The result was also validated in the prospective data with similar results. These findings implied that the clinical response can be regarded as an independent predictor of DFS.