针对侵袭性皮肤状细胞癌的基于欧洲共识的跨学科指南:第二部分. 治疗更新-2023 年
Alexander J Stratigos1, Claus Garbe2, Clio Dessinioti1
1First Department of Dermatology-Venereology, National and Kapodistrian University of Athens, Andreas Sygros Hospital, Athens, Greece.
概括
更新的指南提供了基于证据的建议,用于侵袭性皮肤状细胞癌 (cSCC) 治疗,包括手术,放射治疗和系统治疗,如晚期病例的抗PD-1药物. 强调以患者为中心的护理和多学科决策.
科学领域:
- 皮肤瘤学 皮肤瘤学
- 临床瘤学临床瘤学
- 基于证据的医学是基于证据的医学.
背景情况:
- 侵袭性皮肤状细胞癌 (cSCC) 需要更新治疗指南.
- 一个多学科专家小组被召集来解决这个需求.
- 现有的建议需要整合和基于证据的更新.
研究的目的:
- 更新对侵袭性cSCC患者的治疗,支持性护理,教育和随访的建议.
- 为管理cSCC提供一个全面的,基于证据的框架.
- 为了在cSCC的不同阶段和风险概况中标准化护理.
主要方法:
- 进行了基于证据的文献综述.
- 分析了现有的指导方针.
- 专家通过一个多学科小组达成共识.
主要成果:
- 初级cSCC的第一线治疗包括外科切除或微图控制的手术.
- 辅助放射疗法对高风险局部cSCC具有有限的益处,显而易见的边缘.
- 建议使用抗PD-1药物作为不可切除或转移性cSCC的第一线全身治疗.
- 对于已确认的区域结节转移,建议进行淋巴结解剖.
- 多学科的董事会决策对于先进的cSCC管理至关重要.
结论:
- 更新的建议涵盖了cSCC的范围,从原发性疾病到转移性疾病.
- 手术管理是可切除cSCC的关键,而放射治疗为非手术候选人提供服务.
- 包括抗PD-1药物在内的全身疗法对于高级cSCC至关重要.
- 共享决策,支持性护理和量身定制的随访是患者管理的组成部分.
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