Coia L R, Minsky B D, John M J, Haller D, Landry J, Pisansky T M, Willet C G, Mahon I, Owen J, Hanks G E
Department of Radiation Oncology, Community Medical Center, Toms River, New Jersey 08755, USA.
Radiat Med. 1998 Jul-Aug;16(4):321-7.
The Patterns of Care Study (PCS) of the American College of Radiology periodically develops a decision tree and current management guidelines for major malignancies where radiation has an important role. The decision tree is a framework which depicts the division of patients into treatment groups. The treatment guidelines are useful in management and also serve as a starting point for quality assessment. For the first time, PCS decided to develop consensus management guidelines for esophageal cancer.
A consensus panel was convened to define the key issues and develop guidelines for esophageal cancer management. A modified Delphi process was used to achieve consensus.
The consensus panel developed guidelines for the management of patients with adenocarcinoma or squamous cell carcinoma of the esophagus with a Karnofsky performance status of over 50. Patients with clinical stage I or II esophageal cancer can be treated with curative intent using either a primary surgical or primary chemoradiation approach. For patients with clinical stage III malignancy, where the most common approaches are palliative, surgical resection is generally not recommended and chemoradiation is the preferred treatment.
The PCS has developed treatment guidelines for esophageal cancer based on consensus committee deliberations. These guidelines can be useful for those who manage esophageal cancer.
美国放射学会的治疗模式研究（PCS）定期为放疗起重要作用的主要恶性肿瘤制定决策树和当前管理指南。决策树是一个将患者分为不同治疗组的框架。治疗指南对管理很有用，也是质量评估的起点。PCS首次决定为食管癌制定共识管理指南。
召集了一个共识小组来确定关键问题并制定食管癌管理指南。采用改良的德尔菲法达成共识。
共识小组为卡氏功能状态超过50的食管腺癌或鳞状细胞癌患者制定了管理指南。临床I期或II期食管癌患者可采用根治性手术或根治性放化疗方法进行治疗。对于临床III期恶性肿瘤患者，最常见的治疗方法是姑息治疗，一般不建议手术切除，放化疗是首选治疗方法。
PCS基于共识委员会的审议制定了食管癌治疗指南。这些指南对食管癌管理者可能有用。
