2018-2022 年日本晚期胸腺瘤和晚期胸腺癌的治疗实践：一项全国性分析
Advanced Thymoma and Advanced Thymic Carcinoma Treatment Practices in 2018-2022: A Nationwide Analysis in Japan.
作者
作者单位
- Department of Public Health and Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
- Department of Respiratory Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
摘要
中文
胸腺瘤和胸腺癌是罕见疾病，临床证据有限。本研究旨在调查日本 III 期和 IV 期胸腺瘤或胸腺癌的临床特征和治疗实践。我们分析了 2018 年至 2022 年间诊断的 III 期和 IV 期胸腺瘤和胸腺癌病例，这些病例记录在将医院癌症登记与诊断程序组合调查相关联的全国性数据集中。评估了治疗实践，包括围手术期化疗、放疗和新一代全身治疗的使用情况以及化疗方案。共识别出 556 例 III 期胸腺瘤、312 例 III 期胸腺癌、431 例 IV 期胸腺瘤和 976 例 IV 期胸腺癌患者。完全切除后术后放疗在 III 期胸腺癌中比胸腺瘤更常见（34.1% 对 10.7%），而围手术期化疗在 IV 期胸腺瘤中比胸腺癌使用更频繁（术前：15.5% 对 3.7%；术后：8.4% 对 4.4%）。对于 IV 期胸腺瘤，阿霉素-顺铂-长春新碱-环磷酰胺是最常见的方案（41.8%），而卡铂-紫杉醇主要用于 IV 期胸腺癌（99.5%）。IV 期胸腺瘤中蒽环类为基础的治疗比例从 50.0% 增加到 77.8%，而 III 期胸腺瘤的术后放疗比例从 11.1% 下降到 4.1%。基于证据的胸腺瘤和胸腺癌治疗方法已在日本广泛采用。
English
Thymomas and thymic carcinomas are rare diseases with limited clinical evidence. This study aimed to investigate the clinical characteristics of and treatment practices for Stages III and IV thymoma or thymic carcinoma in Japan. We analyzed cases of Stage III and IV thymoma and thymic carcinoma diagnosed between 2018 and 2022 and recorded in a nationwide dataset linking the Hospital-based Cancer Registry and the Diagnosis Procedure Combination survey. Treatment practices, including the use of perioperative chemotherapy, radiotherapy, and newer systemic therapies as well as the chemotherapy regimens, were evaluated. Overall, 556 stage III thymoma, 312 stage III thymic carcinoma, 431 stage IV thymoma, and 976 stage IV thymic carcinoma patients were identified. Postoperative radiotherapy after complete resection was more common for stage III thymic carcinoma than for thymoma (34.1% vs. 10.7%), while perioperative chemotherapy was used more frequently for stage IV thymoma than for thymic carcinoma (preoperative: 15.5% vs. 3.7%; postoperative: 8.4% vs. 4.4%). For stage IV thymoma, adriamycin-cisplatin-vincristine-cyclophosphamide was the most common regimen (41.8%), whereas carboplatin-paclitaxel was predominantly used for stage IV thymic carcinoma (99.5%). The proportion of anthracycline-based therapy for stage IV thymoma increased from 50.0% to 77.8%, while that of postoperative radiotherapy for stage III thymoma decreased from 11.1% to 4.1%. Evidence-based treatment approaches for thymoma and thymic carcinoma have been widely adopted in Japan.
分类与指标
- 研究类型
- 临床研究
- 病种
- 纵隔肿瘤
- JCR 分区
- Q2
- 影响因子
- 2.6
- 新锐分区
- 4区