J Natl Compr Canc Netw. 2014 Jul;12(7):1028-59. doi: 10.6004/jnccn.2014.0099.
The NCCN Guidelines for Colon Cancer address diagnosis, pathologic staging, surgical management, perioperative treatment, posttreatment surveillance, management of recurrent and metastatic disease,and survivorship. This portion of the guidelines focuses on the use of systemic therapy in metastatic disease. The management of metastatic colorectal cancer involves a continuum of care in which patients are exposed sequentially to a variety of active agents, either in combinations or as single agents. Choice of therapy is based on the goals of treatment, the type and timing of prior therapy, the different efficacy and toxicity profiles of the drugs, the mutational status of the tumor, and patient preference.
NCCN 结肠癌指南涵盖了结肠癌的诊断、病理分期、手术治疗、围手术期治疗、治疗后监测、复发性和转移性疾病的管理以及生存问题。本指南的这一部分侧重于转移性疾病的系统治疗。转移性结直肠癌的管理涉及一系列的治疗方法,在此过程中,患者会依次使用各种有效的药物,包括联合用药和单药治疗。治疗方案的选择取决于治疗目标、既往治疗的类型和时间、药物的不同疗效和毒性特征、肿瘤的突变状态以及患者的偏好。