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导管原位癌的管理:安大略省卫生厅(安大略癌症护理)临床实践指南

Management of Ductal Carcinoma In Situ: An Ontario Health (Cancer Care Ontario) Clinical Practice Guideline.

作者信息

Brackstone Muriel, Durocher-Allen Lisa, Califaretti Nadia, Eisen Andrea, Knowles Sarah, Salim Abeer, Plexman Taude, Koch C Anne

机构信息

London Health Sciences Centre-London Regional Cancer Program, Victoria Hospital, 800 Commissioners Road East, London, ON N6A 5W9, Canada.

Program in Evidence-Based Care, Ontario Health (Cancer Care Ontario), 699 Concession Street, Hamilton, ON L8V 1C3, Canada.

出版信息

Curr Oncol. 2024 Dec 3;31(12):7738-7753. doi: 10.3390/curroncol31120569.

Abstract

(1) Background: To make recommendations on the most effective therapy options for Ductal Carcinoma of the Breast (DCIS) patients; (2) Methods: MEDLINE, EMBASE, Cochrane Library, PROSPERO databases, and main relevant guideline websites were searched. Draft versions of the guideline went through formal internal and external reviews, with a final approval by the Program in Evidence Based Care and the DCIS Expert Panel. The Grading of Recommendations, Assessment, Development, and Evaluation approach was followed; (3) Results: Based on the current evidence from the systematic review and this guideline authors' clinical opinions, initial draft recommendations were developed to improve the management of patients with DCIS. After a comprehensive internal and external review process, ten recommendations and 27 qualifying statements were eventually made. This guideline includes recommendations for the primary treatment of DCIS with surgical treatment and/or radiation therapy and the management of DCIS after primary treatment for patients with DCIS, including DCIS with microinvasion (<1 mm through the duct); (4) Conclusions: The current guideline was created after a systematic review and a comprehensive internal and external review process. We believe this guideline provides valuable insights that will be useful in clinical decision making for health providers.

摘要

(1) 背景:为乳腺癌导管原位癌(DCIS)患者推荐最有效的治疗方案;(2) 方法:检索MEDLINE、EMBASE、Cochrane图书馆、PROSPERO数据库及主要相关指南网站。指南草案经过正式的内部和外部评审,最终由循证医疗项目和DCIS专家小组批准。遵循推荐分级、评估、制定和评价方法;(3) 结果:基于系统评价的现有证据和本指南作者的临床意见,制定了初步草案推荐意见,以改善DCIS患者的管理。经过全面的内部和外部评审过程,最终提出了10条推荐意见和27条限定性声明。本指南包括DCIS手术治疗和/或放射治疗的初始治疗推荐意见,以及DCIS患者(包括伴有微浸润的DCIS,即浸润深度<1mm)初始治疗后的管理推荐意见;(4) 结论:本现行指南是在系统评价和全面的内部和外部评审过程之后制定的。我们相信本指南提供了有价值的见解,将有助于医疗服务提供者进行临床决策。

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