亲爱的研友该休息了!由于当前在线用户较少,发布求助请尽量完整地填写文献信息,科研通机器人24小时在线,伴您度过漫漫科研夜!身体可是革命的本钱,早点休息,好梦!

Total Neoadjuvant Therapy Versus Standard Neoadjuvant Chemoradiation in Patients with Locally Advanced Rectal Cancer

医学 新辅助治疗 腹会阴切除术 结直肠癌 队列 临床终点 内科学 入射(几何) 肿瘤科 癌症 随机对照试验 光学 物理 乳腺癌
作者
Paolo Goffredo,Adil Khan,Sarah L. Mott,Christine C. Jensen,Robert D. Madoff,Wolfgang B. Gaertner,Yijie You,Imran Hassan
出处
期刊:Annals of Surgery [Lippincott Williams & Wilkins]
卷期号:276 (6): e819-e824 被引量:20
标识
DOI:10.1097/sla.0000000000005141
摘要

To evaluate the impact of neoadjuvant multi-agent systemic chemotherapy and radiation (TNT) vs neoadjuvant single-agent chemoradiation (nCRT) and multi-agent adjuvant chemotherapy on overall survival (OS), tumor downstaging, and circumferential resection margin (CRM) status in patients with locally advanced rectal cancer.Outside of clinical trials and small institutional reports, there is a paucity of data regarding the short and long-term oncologic impact of TNT as compared to nCRT.Adult patients with stage II-III rectal adenocarcinoma were identified in the National Cancer Database [2006-2015].Out of 8,548 patients, 36% received TNT and 64% nCRT. In the cohort, 13% had a pCR and 20% a neoadjuvant rectal (NAR) score <8. In multivariable analysis, as compared to nCRT, TNT demonstrated numerically higher pCR rates ( P = 0.05) but had similar incidence of positive CRM ( P = 0.11). Similar results were observed with NAR scores <8 as the primary endpoint. After adjusting for confounders, OS was comparable between the 2 groups. Additional factors independently associated with lower OS included male gender, uninsured status, low income status, high comorbidity score, poorly differentiated tumors, abdominoperineal resection, and positive surgical margins (all P <0.01). In separate models, both pCR and a NAR score <8 were associated with improved OS.In this national cohort, TNT was not associated with better survival and/or CRM negative status in comparison with nCRT, despite numerically higher downstaging rates. Further refinement of patient selection and treatment regimens are needed to establish effective neoadjuvant platforms to improve outcomes of patients with rectal cancer.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
PDF的下载单位、IP信息已删除 (2025-6-4)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
12秒前
科研通AI2S应助科研通管家采纳,获得10
14秒前
Ma发布了新的文献求助10
18秒前
1234完成签到,获得积分10
30秒前
岁和景明完成签到 ,获得积分10
33秒前
科研通AI5应助Ma采纳,获得10
36秒前
西蓝花香菜完成签到 ,获得积分10
43秒前
1分钟前
1分钟前
2分钟前
科研通AI2S应助科研通管家采纳,获得10
2分钟前
科研通AI2S应助科研通管家采纳,获得10
2分钟前
Ma发布了新的文献求助10
2分钟前
2分钟前
科研通AI5应助Ma采纳,获得10
2分钟前
忧伤的绍辉完成签到 ,获得积分10
2分钟前
隐形曼青应助易四夕采纳,获得10
2分钟前
3分钟前
易四夕发布了新的文献求助10
3分钟前
3分钟前
3分钟前
Ma发布了新的文献求助10
4分钟前
4分钟前
随机子发布了新的文献求助10
4分钟前
4分钟前
Ava应助科研通管家采纳,获得10
4分钟前
科目三应助科研通管家采纳,获得10
4分钟前
科研通AI2S应助科研通管家采纳,获得10
4分钟前
Ma发布了新的文献求助10
4分钟前
Ma完成签到,获得积分10
5分钟前
5分钟前
易四夕发布了新的文献求助10
5分钟前
5分钟前
6分钟前
英姑应助王大壮采纳,获得10
6分钟前
SciGPT应助科研通管家采纳,获得10
6分钟前
6分钟前
6分钟前
6分钟前
Mine发布了新的文献求助10
6分钟前
高分求助中
A new approach to the extrapolation of accelerated life test data 1000
Cognitive Neuroscience: The Biology of the Mind 1000
Technical Brochure TB 814: LPIT applications in HV gas insulated switchgear 1000
Immigrant Incorporation in East Asian Democracies 600
Nucleophilic substitution in azasydnone-modified dinitroanisoles 500
不知道标题是什么 500
A Preliminary Study on Correlation Between Independent Components of Facial Thermal Images and Subjective Assessment of Chronic Stress 500
热门求助领域 (近24小时)
化学 材料科学 医学 生物 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 遗传学 基因 物理化学 催化作用 冶金 细胞生物学 免疫学
热门帖子
关注 科研通微信公众号,转发送积分 3968504
求助须知:如何正确求助?哪些是违规求助? 3513278
关于积分的说明 11167214
捐赠科研通 3248660
什么是DOI,文献DOI怎么找? 1794386
邀请新用户注册赠送积分活动 875030
科研通“疑难数据库(出版商)”最低求助积分说明 804638