Department of Radiation Oncology, University of California Davis Comprehensive Cancer Center, Sacramento, CA.
Department of Radiation Oncology, University of California Davis Comprehensive Cancer Center, Sacramento, CA.
Semin Oncol. 2017 Oct;44(5):303-309. doi: 10.1053/j.seminoncol.2018.01.007. Epub 2018 Feb 9.
Lung cancer is the leading cause of cancer death worldwide. Recurrence rates at all stages are high, but evidence-based post-treatment surveillance imaging strategies to detect recurrence are poorly defined, and salvage options are frequently limited. A number of national and international oncology guidelines address post-treatment imaging, but are largely based on low-level, retrospective evidence because of a paucity of high-quality data, particularly in regard to cost-effectiveness and quality-of-life endpoints. Given the lack of randomized data addressing appropriate surveillance imaging modality and interval following definitive treatment of lung cancer, there remains an unmet clinical need. Meaningful surveillance endpoints should include the financial impact, patient quality-of-life outcomes, and access-to-care issues associated with intensive follow-up to ensure that guidelines reflect quality and sustainability. A need for prospective randomized data on the subject of imaging surveillance after definitive local therapy remains an unmet need, and an opportunity for collaboration and further research.
肺癌是全球癌症死亡的主要原因。各阶段的复发率都很高，但缺乏基于循证的复发后治疗监测成像策略，挽救选择也经常受到限制。许多国家和国际肿瘤学指南都涉及治疗后成像，但主要基于低水平的回顾性证据，因为高质量数据，特别是关于成本效益和生活质量终点的数据很少。由于缺乏关于肺癌确定性治疗后适当监测成像方式和间隔的随机数据，因此仍然存在未满足的临床需求。有意义的监测终点应包括与强化随访相关的财务影响、患者生活质量结果以及获得护理的问题，以确保指南反映质量和可持续性。在明确的局部治疗后成像监测领域仍需要前瞻性随机数据，这为合作和进一步研究提供了机会。
