在实施直肠癌非手术管理时的监测挑战
Bailey K Hilty Chu1, Anthony Loria1, Totadri Dhimal1
1Surgical Health Outcomes and Reaching for Equity (SHORE), Department of Surgery, University of Rochester Medical Center, Rochester, New York.
大多数接受非手术治疗的直肠癌患者没有遵守国家综合癌症网络 (NCCN) 监测指南. 然而,监测强度并没有影响生理结果,这表明需要优化监测策略.
科学领域:
- 在瘤学瘤学.
- 临床研究 临床研究
- 癌症监测 癌症监测
背景情况:
- 密切监测对于在经过新辅助疗法后进行非手术治疗的直肠癌患者中检测局部瘤复发至关重要.
- 关于在这种患者群体中遵守国家综合癌症网络 (NCCN) 监测指南的数据有限.
研究的目的:
- 确定接受直肠癌非手术治疗的患者遵守NCCN推的监测率.
- 评估监测强度与瘤结果之间的关系.
主要方法:
- 对85名临床I-III期直肠癌患者进行了回顾性队列研究,这些患者接受了新辅助疗法和非手术治疗.
- 对遵守NCCN监测指南和瘤结果的分析,包括局部再生和远程转移.
主要成果:
- 在第一年,只有39.0%的患者实现了NCCN推的监测,到5年降至15.0%.
- 5年总生存率为82.3%,疾病特异性生存率为95.1%.
- 局部再生发生在24.7%的患者中,远程转移发生在12.9%的患者中,根据监测强度没有显著差异.
结论:
- 大多数接受直肠癌非手术治疗的患者不遵守NCCN监测指南.
- 监测强度与瘤结果没有相关性,这表明需要对可行的监测方案进行前性评估.
- 需要进一步的研究来探索患者的偏好和最佳监测障碍.
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