加拿大共识：寡进展性、假进展性和寡转移性非小细胞肺癌。
Canadian consensus: oligoprogressive, pseudoprogressive, and oligometastatic non-small-cell lung cancer.
机构信息
Ontario: The Ottawa Hospital Cancer Centre, University of Ottawa, Ottawa (Laurie); Division of Medical Oncology, The Ottawa Hospital, University of Ottawa, Ottawa (Brule); University of Toronto, Toronto, and William Osler Health System, Brampton (Cheema); Sunnybrook Odette Cancer Centre, Department of Radiation Oncology, University of Toronto, Toronto (Cheung); McMaster University, Juravinski Cancer Centre, Hamilton (Juergens); Division of Medical Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto (Leighl); University of Ottawa, The Ottawa Hospital, Ottawa (MacRae); University of Ottawa, Ottawa (Nicholas); R.S. McLaughlin Durham Regional Cancer Centre, Lakeridge Health, Oshawa, and Queen's University, Kingston (Rothenstein); The Ottawa Hospital, The Ottawa Hospital Research Institute, and Division of Medical Oncology, University of Ottawa, Ottawa (Stewart); University Health Network, Princess Margaret Cancer Centre, and University of Toronto, Toronto (Tsao).
Manitoba: Rady Faculty of Health Sciences, University of Manitoba, and Medical Oncology, CancerCare Manitoba, Winnipeg.
出版信息
Curr Oncol. 2019 Feb;26(1):e81-e93. doi: 10.3747/co.26.4116. Epub 2019 Feb 1.
BACKGROUND
Little evidence has been generated for how best to manage patients with non-small-cell lung cancer (nsclc) presenting with rarer clinical scenarios, including oligometastases, oligoprogression, and pseudoprogression. In each of those scenarios, oncologists have to consider how best to balance efficacy with quality of life, while maximizing the duration of each line of therapy and ensuring that patients are still eligible for later options, including clinical trial enrolment.
METHODS
An expert panel was convened to define the clinical questions. Using case-based presentations, consensus practice recommendations for each clinical scenario were generated through focused, evidence-based discussions.
RESULTS
Treatment strategies and best-practice or consensus recommendations are presented, with areas of consensus and areas of uncertainty identified.
CONCLUSIONS
In each situation, treatment has to be tailored to suit the individual patient, but with the intent of extending and maximizing the use of each line of treatment, while keeping treatment options in reserve for later lines of therapy. Patient participation in clinical trials examining these issues should be encouraged.
背景
对于如何最好地管理表现出罕见临床情况的非小细胞肺癌（nsclc）患者，例如寡转移、寡进展和假性进展，几乎没有产生任何证据。在这些情况下，肿瘤学家必须考虑如何在平衡疗效和生活质量的同时，最大限度地延长每一线治疗的持续时间，并确保患者仍然有资格选择后续治疗方案，包括临床试验入组。
方法
召集了一个专家小组来定义临床问题。通过基于案例的介绍，通过集中的、基于证据的讨论，针对每个临床情况生成了共识实践建议。
结果
提出了治疗策略和最佳实践或共识建议，并确定了共识领域和不确定领域。
结论
在每种情况下，治疗都必须针对个体患者进行调整，但旨在延长和最大化每一线治疗的使用，同时为后续治疗线保留治疗选择。应鼓励患者参与研究这些问题的临床试验。
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