田园, 杨沛刚, 李勇, 范立侨, 张志栋, 王冬, 赵雪峰, 赵群. 进展期胃癌新辅助治疗后病理完全缓解相关因素分析及风险预测模型建立[J]. 中国肿瘤临床, 2020, 47(16): 829-834. DOI: 10.3969/j.issn.1000-8179.2020.16.688
引用本文: 田园, 杨沛刚, 李勇, 范立侨, 张志栋, 王冬, 赵雪峰, 赵群. 进展期胃癌新辅助治疗后病理完全缓解相关因素分析及风险预测模型建立[J]. 中国肿瘤临床, 2020, 47(16): 829-834. DOI: 10.3969/j.issn.1000-8179.2020.16.688
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Tian Yuan, Yang Peigang, Li Yong, Fan Liqiao, Zhang Zhidong, Wang Dong, Zhao Xuefeng, Zhao Qun. Risk prediction model and factors related to pathological complete response after neoadjuvant therapy for advanced gastric cancer[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2020, 47(16): 829-834. DOI: 10.3969/j.issn.1000-8179.2020.16.688
Citation: Tian Yuan, Yang Peigang, Li Yong, Fan Liqiao, Zhang Zhidong, Wang Dong, Zhao Xuefeng, Zhao Qun. Risk prediction model and factors related to pathological complete response after neoadjuvant therapy for advanced gastric cancer[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2020, 47(16): 829-834. DOI: 10.3969/j.issn.1000-8179.2020.16.688
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进展期胃癌新辅助治疗后病理完全缓解相关因素分析及风险预测模型建立

Risk prediction model and factors related to pathological complete response after neoadjuvant therapy for advanced gastric cancer

    摘要
  • 摘要:
      目的  探讨局部进展期胃癌新辅助治疗后病理完全缓解（pathological complete response，pCR）的临床相关因素。
      方法  回顾性分析2011年6月至2018年3月河北医科大学第四医院收治的452例局部进展期胃癌患者cT3~4N+~M0新辅助治疗及手术的临床资料，采用单因素分析及Logistic多因素回归分析法研究pCR的临床相关因素。
      结果  452例患者全部完成新辅助治疗及根治性手术，其中44例（9.7%）患者达到pCR。治疗前T分期为T3期、肿瘤最长径 < 4 cm、治疗前CA199≤30 U/mL、治疗结束与手术时间间隔≥6周、同步放化疗或联合靶向治疗方案与进展期胃癌新辅助治疗后高pCR率有关（均P < 0.05）。治疗前T分期为T3期、CA199≤30 U/mL、肿瘤最长径 < 4 cm、新辅助同步放化疗或联合靶向治疗是影响进展期胃癌新辅助治疗后出现pCR的独立因素（均P < 0.05）。以上每项指标出现pCR的预测评分均为1分。评分>2分患者出现pCR的概率为34.48%，评分≤2分患者出现pCR的概率为6.09%。
      结论  治疗前临床分期、CA199水平、肿瘤最长径及治疗模式是进展期胃癌新辅助治疗后达到pCR的影响因素，通过预测评分模型能有效识别其发生率。

     

    Abstract:
      Objective  To investigate the baseline characteristics of pathological complete response (pCR) after neoadjuvant therapy for locally advanced gastric cancer.
      Methods  From June 2011 to March 2018, 452 patients with locally advanced gastric cancer (cT3/4N0/+M0) admitted to the Fourth Hospital of Hebei Medical University were retrospectively analyzed, and the clinical factors related to pCR were studied using Logistic univariate and multivariate regression analyses.
      Results  All 452 patients completed neoadjuvant therapy and underwent radical surgery, and 44 (9.7%) of them achieved pCR. T3 stage before neoadjuvant therapy, a maximum tumor diameter < 4 cm, a carbohydrate antigen 19-9 (CA199) level ≤ 30 U/mL before treatment, end of treatment with an operative interval of ≥ 6 weeks, concurrent chemoradiotherapy, and the use of a combined targeted therapy regimen were associated with a high pCR rate after neoadjuvant therapy for locally advanced gastric cancer. T3 stage, CA199 levels ≤ 30 U/mL, a maximum tumor diameter < 4 cm, concurrent chemoradiotherapy, and the use of combined targeted therapy before treatment were independent factors influencing the occurrence of pCR after neoadjuvant therapy for advanced gastric cancer. Each of these parameters was assigned 1 point. The probability of pCR was 34.48% among patients with a score >2 and 6.09% among patients with a score ≤ 2.
      Conclusions  The pretreatment clinical stage, CA199 level, tumor size, and treatment pattern influence the occurrence of pCR after neoadjuvant therapy, and the incidence can be effectively identified by a predictive scoring model.

     

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