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JAMA Surg:早期肛管鳞状细胞癌患者治疗方案比较研究——局部切除vs同步放化疗

2017-10-20 zhangfan MedSci原创

研究认为对于早期肛管鳞状细胞癌患者,接受局部切除后的生存期非劣于同步放化疗,且手术疗法的成本低,患者痛苦少

近年来肛管鳞状细胞癌(SCCAC)的发病率不断增加。目前SCCAC标准治疗方案为同步放化疗,但对于潜在疾病进展和其他治疗方案的研究十分缺乏。近日研究人员考察了对SCCAC T1阶段患者采取局部切除的疗效,比较手术与放化疗对患者生存期的影响。

研究人员对国家癌症数据库2004-2012年相关研究资料进行回顾分析,2243名,年龄18-80岁,SCCAC  T1N0M0期患者参与,利用Cox比例风险回归模型评估整体死亡率与治疗方法之间的关联

2243名患者中,503人(22.4%)接受单纯局部切除治疗,1740接受放化疗。对于接受放化疗的患者,12人后续接受腹会阴联合切除术。在研究期间,局部切除治疗的使用率显著增加,由2004年的34例(17.3%)上升为2012年的68例(30.8%),对于小于1cm的以及1-2cm的原发性肿瘤患者,手术治疗的比例显著增加。组间5年生存期无显著差异(局部切除组85.3%,放化疗组86.8%),总死亡风险组间无显著差异(HR,1.06;95% CI,0.78-1.44),参与研究的患者肿瘤大小相当且排除腹会阴联合切除术后放化疗的患者。

研究认为对于早期肛管鳞状细胞癌患者,接受局部切除后的生存期非劣于同步放化疗,且手术疗法的成本低,患者痛苦少。

原始出处:

Christy Y et al. Management of Stage I Squamous Cell Carcinoma of the Anal Canal. JAMA Surg. October 18 2017.

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    2017-10-22 yzh399
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    2017-10-22 chg122
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    2017-10-20 Y—xianghai

    学习了新知识

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