低分泌性食道胃癌:它是否存在,我们如何治疗它?
Tiuri E Kroese1, Sebastiaan F C Bronzwaer2, Peter S N van Rossum3
1Department of Radiation Oncology, University Hospital Zürich, University of Zurich, Rämistrasse 100, Zürich, 8091, Switzerland. Tiuri.Kroese@usz.ch.
对新发性食管胃寡度转移性疾病 (OMD) 的治疗方法各不相同. 虽然一些试验显示增加局部治疗没有生存益处,但其他试验表明改善了结果,强调了严格选择患者的必要性.
科学领域:
- 在瘤学瘤学.
- 胃肠病学 胃肠病学
背景情况:
- 寡质转移性疾病 (OMD) 是局部转移性癌症和广泛转移性癌症之间的中间状态.
- 对新出现的食管胃OMD的最佳治疗策略仍在研究中.
研究的目的:
- 审查最近的随机试验和专家的共识,对 de-novo食道胃OMD.
- 讨论对临床实践和未来试验设计的影响.
主要方法:
- 最近完成的随机试验的叙述性综述.
- 对专家共识建议的分析.
主要成果:
- 在IKF-575/RENAISSANCE试验中,大多数用单独的全身疗法治疗的胃/胃食道结OMD患者与局部和全身疗法联合治疗的患者的生存率没有显著差异.
- ESO-上海13项试验显示,随着对寡基质性食道状细胞癌的局部治疗,改善了无进展和整体存活率.
- 一个欧洲共识 (OMEC项目) 提出了对OMD的限制性定义,强调需要严格选择患者进行局部治疗.
结论:
- 在 de-novo食管胃OMD中,添加局部治疗到全身治疗的证据是混合的,取决于患者的选择.
- 根据组织学和转移位置的分层是至关重要的.
- 需要进一步进行临床试验,以确定最佳的多学科治疗方法,并确定预测性生物标志物.
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