一个国际基于专家的共识,对定义的临床接近完整的响应后新辅助剂 (化疗) 放射治疗直肠癌
Petra A Custers1,2, Geerard L Beets1,2, Simon P Bach3
1Department of Surgery, Netherlands Cancer Institute - Antoni van Leeuwenhoek, Amsterdam, the Netherlands.
Diseases of the colon and rectum
|May 3, 2024
概括
专家们就新辅助疗法后直肠癌患者临床近完全反应的三层定义达成共识. 这种新的分类有助于治疗决策和患者就器官保存可能性的咨询.
科学领域:
- 在瘤学瘤学.
- 辐射疗法 辐射疗法
- 胃肠病学 胃肠病学
背景情况:
- 在治疗直肠癌的新辅助化学放射治疗后临床近完全反应的不一致定义导致临床实践和结果的变化.
- 标准化这一定义对于一致的患者管理和临床试验招生至关重要.
研究的目的:
- 建立一个基于专家的共识,对临床的定义接近完整的响应后,用于直肠癌的新辅助化学放射治疗.
- 开发一个标准化的框架,用于评估直肠癌患者的治疗反应.
主要方法:
- 使用了经过修改的Delphi工艺,涉及国际专家小组 (7名外科医生,4名放射科医生).
- 该过程包括系统性审查,三次在线调查和两次在线会议,讨论内镜,T2加权MRI和扩散加权MRI等功能.
- 共识被定义为小组成员之间80%或更多的协议.
主要成果:
- 在近完全反应的三层分类上达成共识,预测随着时间的推移演变成完全反应的可能性.
- 几乎完全的反应被认为是暂时的状态,在治疗后的前六个月内适用.
- 淋巴结状况是确定接近完全反应的关键因素,而活检并不总是必要的.
结论:
- 通过专家共识建立了近完全反应的三级分类,为临床实践提供了指导.
- 这种框架可以帮助治疗决策,并向患者告知成功保存器官的潜力.
- 需要进一步验证,以确认这种基于专家的分类的概括性和临床实用性.
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