Neoadjuvant chimiotherapie no kubaga imbere ya kanseri yandura

CHICAGO - Chimiotherapie ya Neoadjuvant ntishobora guhuza kubagwa mbere kugirango ibeho kanseri yandura kanseri yandura, nkuko byageragejwe gato.
Mu buryo butunguranye, abarwayi babazwe bwa mbere babayeho igihe kirenga umwaka kurusha abahawe amasomo magufi ya chimiotherapie ya FOLFIRINOX mbere yo kubagwa.Iki gisubizo kiratangaje cyane dore ko ubuvuzi bwa neoadjuvant bujyanye nigipimo kinini cyo kubaga nabi (R0) kandi ko abarwayi benshi mumatsinda yo kuvura bageze kuri status-mbi.
Knut Jorgen Laborie, MD, kaminuza ya Oslo, Noruveje, Sosiyete y'Abanyamerika ishinzwe ubuvuzi bwa Oncology yagize ati: "Ibindi byakurikiranwe birashobora gusobanura neza ingaruka z'igihe kirekire ziterwa no gutera imbere muri R0 na N0 mu itsinda rya neoadjuvant."Inama ya ASCO).Ati: “Ibisubizo ntabwo bishyigikira ikoreshwa rya neoadjuvant FOLFIRINOX nk'ubuvuzi busanzwe bwa kanseri yandura.
Iki gisubizo cyatunguye Andrew H. Ko, MD, wo muri kaminuza ya Californiya, San Francisco, wari watumiwe muri iki kiganiro, maze yemera ko badashyigikiye neoadjuvant FOLFIRINOX nk'uburyo bwo kubaga imbere.Ariko nanone ntibakuraho ibyo bishoboka.Bitewe ninyungu zimwe mubushakashatsi, ntibishoboka gutanga ibisobanuro byuzuye kubyerekeranye nigihe kizaza cya FOLFIRINOX neoadjuvant.
Ko yavuze ko kimwe cya kabiri cy’abarwayi barangije inzinguzingo enye za chimiotherapie neoadjuvant, “ibyo bikaba biri munsi cyane y'ibyo nari niteze kuri iri tsinda ry'abarwayi, kuri bo uburyo bune bwo kuvura muri rusange ntibugoye…...Icyakabiri, ni ukubera iki Ese uburyo bwiza bwo kubaga no kuvura indwara [R0, N0 status] biganisha ku cyerekezo kiganisha ku ngaruka mbi mu itsinda rya neoadjuvant?sobanukirwa n'impamvu hanyuma amaherezo uhindukire kuri gemcitabine. ”
Ati: "Kubwibyo, ntidushobora rwose gufata imyanzuro ihamye muri ubu bushakashatsi ku bijyanye n'ingaruka zihariye za FOLFIRINOX ku ngaruka zo kubaho.Indwara. ”
Laborie yavuze ko kubaga hamwe no kuvura neza bitanga ibisubizo byiza kuri kanseri yandura.Ubusanzwe, ubuvuzi bwashyizwemo kubaga imbere hamwe na chimiotherapie.Nyamara, ubuvuzi bwa neoadjuvant bukurikirwa no kubagwa hamwe na chimiotherapie yongeyeho byatangiye kwamamara mubantu benshi ba oncologiste.
Ubuvuzi bwa Neoadjuvant butanga inyungu nyinshi zishoboka: kugenzura hakiri kare indwara zifatika, kunoza imitangire ya chimiotherapie, no kunoza ibisubizo bya histopathologique (R0, N0), Laborie yakomeje.Ariko, kugeza ubu, nta kigeragezo cyateganijwe cyerekanye neza inyungu zo kubaho kwa chimiotherapie neoadjuvant.
Mu rwego rwo gukemura ikibazo cyo kubura amakuru mu bigeragezo byateganijwe, abashakashatsi bo mu bigo 12 byo muri Noruveje, Suwede, Danemarke na Finlande bashakishije abarwayi bafite kanseri yo mu mutwe ishobora kwandura.Abarwayi batoranijwe kubagwa imbere bakiriye inzinguzingo 12 zahinduwe na FOLFIRINOX (mFOLFIRINOX).Abarwayi bahabwa imiti ya neoadjuvant bakiriye inzinguzingo 4 za FOLFIRINOX bakurikirwa no gusubiramo inshuro nyinshi no kubagwa, hakurikiraho inzinguzingo 8 za mFOLFIRINOX.Iherezo ryibanze kwari ukubaho muri rusange (OS), kandi ubushakashatsi bwahawe imbaraga zo kwerekana iterambere ryubuzima bwamezi 18 kuva kuri 50% hamwe no kubagwa imbere kugeza 70% hamwe na neoadjuvant FOLFIRINOX.
Amakuru yarimo abarwayi 140 batoranijwe bafite status ya ECOG 0 cyangwa 1. Mu itsinda rya mbere ryo kubaga, 56 ku barwayi 63 (89%) babazwe naho 47 (75%) batangira imiti ivura imiti.Mu barwayi 77 bashinzwe kuvura neoadjuvant, 64 (83%) batangiye kuvura, 40 (52%) barangije kuvura, 63 (82%) barandurwa, naho 51 (66%) batangira kuvura.
Icyiciro cya ≥3 ibintu bibi (AEs) byagaragaye ku barwayi 55,6% bahabwa imiti ya neoadjuvant, cyane cyane impiswi, isesemi no kuruka, na neutropenia.Mugihe cya chimiotherapie, abagera kuri 40% byabarwayi muri buri tsinda rivura bafite uburambe ≥3 AEs.
Mu bushake-bwo-gusesengura, hagati muri rusange kubaho hamwe nubuvuzi bwa neoadjuvant bwabaye amezi 25.1 ugereranije n’amezi 38.5 hamwe no kubagwa imbere, kandi chimiotherapie ya neoadjuvant yongereye ibyago byo kubaho ku kigero cya 52% (95% CI 0.94-22.46, P = 0.06).Umubare w'amezi 18 yo kubaho wari 60% hamwe na neoadjuvant FOLFIRINOX na 73% hamwe no kubagwa imbere.Kuri protocole ivuga ko yatanze ibisubizo bisa.
Ibisubizo bya Histopathologique bishyigikira imiti ya neoadjuvant kuko 56% by'abarwayi bageze kuri R0 ugereranije na 39% by'abarwayi babaga imbere (P = 0.076) naho 29% bakagera kuri N0 ugereranije na 14% by'abarwayi (P = 0.060).Isesengura rya porotokole ryerekanye itandukaniro rishingiye ku mibare hamwe na neoadjuvant FOLFIRINOX muri R0 (59% na 33%, P = 0.011) na N0 (37% na 10%, P = 0.002).
Charles Bankhead ni umwanditsi mukuru wa oncology kandi akubiyemo urology, dermatology na ophthalmology.Yinjiye muri MedPage Uyu munsi mu 2007.
Ubushakashatsi bwatewe inkunga n’umuryango wa kanseri wo muri Noruveje, Ikigo cy’ubuzima mu karere k’amajyepfo y’iburasirazuba bwa Noruveje, Fondasiyo ya Sjoberg yo muri Suwede ndetse n’ibitaro bya kaminuza bya Helsinki.
Ko - .Celgene, CrystalGenomics, Leap Therapeutics hamwe nandi masosiyete.
Inkomoko yatanzwe: Labori KJ n'abandi.“ASC 2023;Ibisobanuro LBA4005.
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