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评估19个国家和国际直肠癌指南中的新辅助疗法建议

Pawel Mroczkowski^1,2,3, Selim Atay⁴, Richard Viebahn⁴

¹Department for Surgery, Ruhr-University-Bochum, Knappschafts-University-Hospital, In der Schornau 23-25, 44892, Bochum, Germany. pawel.mroczkowski@med.ovgu.de.

Techniques in coloproctology

|August 5, 2024

概括

目前的直肠癌指南通常在没有足够的证据的情况下推新辅助治疗,这可能导致不必要的功能障碍. 需要更新以与最新证据保持一致,并改善患者护理.

科学领域:

在瘤学瘤学.
基于证据的医学基于证据的医学.
临床指南临床指南

背景情况:

结直肠癌是一个重大的全球健康挑战,发病率和死亡率很高.
全腹膜切除 (TME) 改善了局部控制,但新辅助治疗的作用和对生活质量的影响需要仔细研究.
新辅助疗法,虽然有可能推进治疗,但可以导致显著的功能障碍和降低生活质量.

研究的目的:

批判性地评估证据支持现行国际直肠癌指南中新辅助治疗建议的证据.
评估指南建议是否与最新的科学证据一致,并考虑患者的生活质量.

主要方法:

在PubMed中对2012年至2022年间发表的论文进行了全面的文献搜索.
在对988篇论文进行初步选后,选择了19篇相关文件 (指南) 进行分析.
审查的重点是新辅助药治疗建议的证据及其对患者治疗结果的影响.

主要成果:

在审查的19条指导方针中,有11条不建议进行前置手术.
12条指导方针未能解决与多模式治疗相关的功能障碍.
新辅助疗法的建议通常依赖于过时的参考资料,并且缺乏基于MRI分期的差异化,导致某些患者亚组的过度治疗.

结论:

结直肠癌治疗指南需要立即修订,以纳入最新的证据并改善患者护理标准.
对准则制定流程进行彻底审查对于防止未来的不一致性和确保基于证据的建议至关重要.

关键词:

准则准则准则准则新辅助疗法是一种新辅助疗法.这是直肠癌.手术手术手术术术

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