Neoadjuvant therapy for oligometastatic colorectal cancer.

Q4 Medicine
J Tomášek, T Staněk
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引用次数: 0

Abstract

Every patient with oligometastatic disease should be discussed within a multidisciplinary team.The intention of treating oligometastatic disease is curative in most cases. Surgical treatment is essential, and can be combined with ablation methods. Oncological criteria that describe the risk of progression/relapse help select patients who benefit most from neoadjuvant/perioperative chemotherapy. For optimal selection of systemic treatment for metastatic colorectal cancer, knowledge of predictive molecular factors is necessary. These include determination of RAS, BRAF and MMR/MSI. The basis of systemic treatment is chemotherapy based on combinations of fluoropyrimidines, oxaliplatin or irinotecan. A special group  includes patients with dMMR/MSI-high tumors, which are very sensitive to the treatment with modern immunotherapy with checkpoint inhibitors. The question of the indication of immunotherapy in the case of resectable metastases has not been resolved yet.

低转移性结直肠癌的新辅助治疗。
每一个患有少转移性疾病的患者都应该在一个多学科的团队中进行讨论。在大多数情况下,治疗少转移性疾病的目的是治愈。手术治疗是必要的,并可结合消融方法。描述进展/复发风险的肿瘤学标准有助于选择从新辅助/围手术期化疗中获益最多的患者。对于转移性结直肠癌的系统治疗的最佳选择,预测性分子因素的知识是必要的。这些包括RAS、BRAF和MMR/MSI的测定。全身治疗的基础是基于氟嘧啶、奥沙利铂或伊立替康联合化疗。一个特殊的群体包括dMMR/ msi高的肿瘤患者,他们对使用检查点抑制剂的现代免疫疗法非常敏感。在可切除转移的情况下,免疫治疗的适应症问题尚未得到解决。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Rozhledy v Chirurgii
Rozhledy v Chirurgii Medicine-Medicine (all)
CiteScore
0.50
自引率
0.00%
发文量
67
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