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怀孕期间癌症的管理:ASCO指南
Alison W Loren1, Christina Lacchetti2, Frédéric Amant3
1Perelman School of Medicine of the University of Pennsylvania, Philadelphia, PA.
怀孕期间的癌症管理需要基于价值观的方法. 系统疗法推迟到第二个三个月,由于胎儿风险,特定药物禁用.
科学领域:
- 在瘤学瘤学.
- 孕产妇和胎儿医学 孕产妇和胎儿医学
- 基于证据的医学基于证据的医学.
背景情况:
- 孕妇癌症的管理对孕妇和胎儿的健康带来了独特的挑战.
- 需要仔细考虑诊断和治疗干预措施.
- 现有证据通常包括观察数据和案例报告.
研究的目的:
- 为孕妇癌症管理制定基于证据的指导方针.
- 为诊断评估和治疗策略提供建议.
- 确保母亲和发育中的胎儿都有最佳的结果.
主要方法:
- 由一个多学科专家小组进行的系统文献审查.
- 分析了450项符合条件的研究,包括观察数据,病例系列和病例报告.
- 综合证据以提供临床建议的信息.
主要成果:
- 确定了大量关于怀孕癌症的文献,主要是观察性.
- 强调需要个性化的诊断和治疗方法.
- 对某些全身疗法的详细具体禁忌.
结论:
- 管理层应优先考虑基于价值观的知情同意流程.
- 诊断成像应遵守尽可能低的合理可实现 (ALARA) 原则.
- 系统性治疗一般推迟到第二个三个月;某些药物是禁忌的. 交付时间和心理社会支持至关重要.
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