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局部晚期食管癌的治疗:ASCO 指南。

Treatment of Locally Advanced Esophageal Carcinoma: ASCO Guideline.

机构信息

New York Hospital/Weill Cornell Medical Center, New York, NY.

American Society of Clinical Oncology, Alexandria, VA.

出版信息

J Clin Oncol. 2020 Aug 10;38(23):2677-2694. doi: 10.1200/JCO.20.00866. Epub 2020 Jun 22.

Abstract

PURPOSE

To develop an evidence-based clinical practice guideline to assist in clinical decision making for patients with locally advanced esophageal cancer.

METHODS

ASCO convened an Expert Panel to conduct a systematic review of the more recently published literature (1999-2019) on therapy options for patients with locally advanced esophageal cancer and provide recommended care options for this patient population.

RESULTS

Seventeen randomized controlled trials met the inclusion criteria. Where possible, data were extracted separately for squamous cell carcinoma and adenocarcinoma.

RECOMMENDATIONS

Multimodality therapy for patients with locally advanced esophageal carcinoma is recommended. For the subgroup of patients with adenocarcinoma, preoperative chemoradiotherapy or perioperative chemotherapy should be offered. For the subgroup of patients with squamous cell carcinoma, preoperative chemoradiotherapy or chemoradiotherapy without surgery should be offered. Additional subgroup considerations are provided to assist with implementation of these recommendations. Additional information is available at www.asco.org/gastrointestinal-cancer-guidelines.

摘要

目的

制定一项基于证据的临床实践指南,以帮助局部晚期食管癌患者进行临床决策。

方法

ASCO 召集了一个专家小组,对近期发表的(1999 年至 2019 年)关于局部晚期食管癌患者治疗选择的文献进行系统回顾,并为这一患者群体提供推荐的护理选择。

结果

17 项随机对照试验符合纳入标准。在可能的情况下,分别为鳞状细胞癌和腺癌提取数据。

建议

建议对局部晚期食管癌患者进行多模式治疗。对于腺癌亚组,应提供术前放化疗或围手术期化疗。对于鳞状细胞癌亚组,应提供术前放化疗或不放疗的放化疗。提供了其他亚组考虑因素,以帮助实施这些建议。更多信息可在 www.asco.org/gastrointestinal-cancer-guidelines 上获得。

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