对I-III期上状细胞癌的全身疗法:ASCO指南
Van K Morris1, Erin B Kennedy2, Manik A Amin3
1MD Anderson Cancer Center, Houston, TX.
概括
对于I-III阶段的门癌症,建议使用米托米辛-C (MMC) 与胺 (甲或甲) 进行化学辐射. 甲与西斯普拉丁是另一种选择,特别是对于免疫抑制患者.
科学领域:
- 在瘤学瘤学.
- 胃肠病学 胃肠病学
背景情况:
- 门癌症的治疗需要基于证据的指导方针,以获得最佳的患者结果.
- 目前的治疗策略涉及化疗辐射,因此需要明确建议使用化疗剂.
研究的目的:
- 为管理I-III期癌提供基于证据的临床实践指南.
- 建立关于最有效的化学辐射疗法方案的共识.
主要方法:
- 明尼苏达州基于证据的实践中心进行了系统的文献审查.
- 美国临床瘤学会 (ASCO) 专家小组审查了证据并提出了建议.
主要成果:
- 三个随机对照试验和三个非随机研究为指南提供了信息.
- 作为放射敏感剂,建议使用米托米辛-C (MMC) 与甲 (甲[FU]或甲) 相结合.
- 与FU一起的西斯普拉丁是一种替代药物,特别是在由于骨髓抑制减少而受到免疫抑制的患者中.
结论:
- 线粒素-C (MMC) 加上胺是门癌最喜欢的放射敏感化疗.
- 西斯普拉丁加FU是一种可行的替代品,特别是对于免疫抑制患者.
- 对于局部癌,不建议进行常规的诱导或巩固化疗.
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