Florou Vaia, Nascimento Antonio G, Gulia Ashish, de Lima Lopes Gilberto
From the Sylvester Comprehensive Cancer Center at the University of Miami, Miami, FL; AC Camargo Cancer Center, Sao Paulo, Brazil; Tata Memorial Hospital, New Delhi, India.
Am Soc Clin Oncol Educ Book. 2018 May 23;38:916-924. doi: 10.1200/EDBK_200589.
Sarcomas, rare and heterogenous malignancies that comprise less than 1% of all cancers, have poor outcomes in the metastatic and refractory setting. Their management requires a multidisciplinary approach that consists of medical and surgical oncologists, radiation oncologists, and pathologists as well as ancillary support. In addition to systemic treatments, most patients will require surgical resection and radiation therapy, which mandates the use of the latest technologies and specialized expertise. Management guidelines have been developed in high-income countries, but their applicability in low-income countries, where resources may be limited, remains a challenge. In this article, we propose the best possible evidence-based practices specifically for income-constrained settings to overcome this challenge. In addition, we review the different methods that can be used in low-income countries to access new and expensive treatments, which often times carry prohibitive costs for these areas.
肉瘤是罕见且异质性的恶性肿瘤,占所有癌症的比例不到1%,在转移性和难治性情况下预后较差。其治疗需要多学科方法,包括医学肿瘤学家、外科肿瘤学家、放射肿瘤学家、病理学家以及辅助支持人员。除了全身治疗外,大多数患者还需要手术切除和放射治疗,这就需要使用最新技术和专业知识。高收入国家已经制定了管理指南,但在资源可能有限的低收入国家,其适用性仍然是一个挑战。在本文中,我们提出了专门针对资源受限环境的最佳循证实践,以克服这一挑战。此外,我们还回顾了低收入国家可用于获取新的昂贵治疗方法的不同途径,而这些治疗方法往往给这些地区带来高昂的成本。