加拿大胆道癌症系统治疗的实用指南
Ravi Ramjeesingh1, Prosanto Chaudhury2, Vincent C Tam3
1Division of Medical Oncology, Department of Medicine, Nova Scotia Health, Dalhousie University, Halifax, NS B3H 2Y9, Canada.
系统治疗对于胆道癌 (BTC) 是至关重要的,因为手术后的复发率很高. 目前的治疗包括capecitabine,gemcitabine-cisplatin与免疫疗法,以及新兴的向药物,尽管最佳的治疗方案和获取仍然是挑战.
科学领域:
- 在瘤学瘤学.
- 胃肠病学 胃肠病学
- 癌症研究 癌症研究
背景情况:
- 胆道癌 (BTC) 是罕见的,侵略性的,并且经常存在不可切除的疾病或高的术后复发率.
- 系统疗法是管理BTC的关键组成部分,特别是当治疗性手术不是一种选择或切除后.
- 目前对高级BTC的治疗策略包括化疗和免疫疗法,正在对向药物进行研究.
研究的目的:
- 在加拿大医疗保健背景下,提供关于胆道癌 (BTC) 系统治疗的实用指南.
- 审查目前的证据和新兴的BTC治疗方法在不同疾病阶段 (辅助性,新辅助性,高级/转移性).
- 突出BTC系统治疗的挑战和未来方向,包括获得向治疗.
主要方法:
- 审查目前的全身治疗指南和胆道癌症临床试验数据.
- 分析标准护理方案,包括化疗,免疫疗法组合和向药物.
- 对切除性,边缘切除性和高级/转移性BTC的治疗方法的讨论.
主要成果:
- 建议在治疗切除后的辅助设置中使用capecitabine.
- 杰米西塔-西斯普拉丁加上杜尔瓦卢马布是高级不可切除/转移性BTC的标准;布罗利祖马布组合也显示了生存益处.
- 最佳治疗方案后进展和获得向药物的机会仍然是需要进一步调查和改进的领域.
结论:
- 系统疗法是所有阶段胆道癌症管理的组成部分.
- 虽然已建立的治疗方案存在,但优化治疗序列和改善获得新型向治疗的机会是未来的关键挑战.
- 本指南提供了对加拿大BTC当前和未来系统性治疗策略的见解.
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