美国镭学会宫颈食管鳞状细胞癌适当使用标准的执行摘要:系统回顾和指南

IF 1.8 4区 医学 Q4 ONCOLOGY
Vonetta M Williams, Christopher L Hallemeier, Krishan R Jethwa, J Eva Selfridge, Pari Shah, Christopher J Anker, Gerard Abood, Dmitriy Akselrod, Jordan Berlin, Ed Kim, Timothy Kennedy, Percy Lee, Navesh Sharma, Small William, Leila Tchelebi, Suzanne Russo
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引用次数: 0

摘要

目的:宫颈食管癌(CEC)是一种罕见的恶性肿瘤。方法:使用人群、干预、比较物、结果、时间和研究设计(PICOTS)框架,使用Cochrane和PRISMA 2020方法评估有关治疗结果的证据。符合条件的研究包括2013年1月1日至2024年2月23日在Ovid Medline数据库中发表的前瞻性II至III期试验和回顾性分析。这些参考文献通过美国镭学会(ARS)适当使用标准(AUC)方法进行评估。系统审查PRISMA 2020检查表确认了基本要素的完成。兰德-加州大学洛杉矶分校的共识方法被专家小组用来评价治疗方案的适当性。结果:ARS AUC的建议包括(1)对于pT1a cN0 cM0 CEC的典型病例,单独使用内镜切除(EMR或ESD)保存喉部;(2)对于不能行内镜切除的cT1bN0M0 CEC的典型病例,使用明确的CRT(伴或不伴诱导化疗);(3)对于非转移性局部晚期CEC的典型病例(晚期t期肿瘤或受病灶淋巴结),使用明确的CRT(伴或不伴诱导化疗)保存喉部。手术保留给不完全缓解或局部复发的患者。结论:ARS AUC总结基于现有证据为颈段食管SCC的治疗提供了指导。值得进一步研究的课题包括:(1)患者选择的优化;(2)多模式治疗,包括化疗、免疫治疗和靶向药物;(三)辐射剂量、方案和治疗量;(4)对CEC患者的支持性护理。正在进行的试验继续改善CEC患者的预后。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Executive Summary of the American Radium Society Appropriate Use Criteria for Management of Squamous Cell Carcinoma of the Cervical Esophagus: Systematic Review and Guidelines.

Objectives: Cervical esophageal cancer (CEC) is an uncommon malignancy accounting for <5% of all esophageal carcinomas. Treatment of CEC varies and is adapted from established regimens used for squamous cell carcinoma (SCC) or the lower esophageal and head and neck. The present systematic review and guidelines are intended to assist treatment decision making for patients with CEC based on the available evidence.

Methods: Using the Population, Intervention, Comparator, Outcome, Timing, and Study Design (PICOTS) framework, the evidence regarding treatment outcomes was assessed using Cochrane and PRISMA 2020 methodology. Eligible studies included prospective Phase II to III trials and retrospective analyses published between January 1, 2013 and February 23, 2024 in the Ovid Medline database. These references were assessed through the American Radium Society (ARS) Appropriate Use Criteria (AUC) methodology. A systematic review PRISMA 2020 checklist confirmed the completion of essential elements. RAND-UCLA consensus methodology was used by the expert panel to rate the appropriateness of the treatment options.

Results: ARS AUC recommendations include (1) larynx preservation using endoscopic resection (EMR or ESD) alone for the typical case with pT1a cN0 cM0 CEC, (2) definitive CRT for the typical case with cT1bN0M0 in patients who cannot undergo endoscopic resection, (3) larynx-preserving using definitive CRT (with or without induction chemotherapy) for the typical case with nonmetastatic locally advanced CEC (advanced T-stage tumors or involved lymph nodes), with surgery reserved for those patients with incomplete response or locoregional recurrence.

Conclusions: This ARS AUC summary provides guidelines for the management of SCC of the cervical esophagus provides based on available evidence. Topics that warrant further investigation include optimization of (1) patient selection; (2) multimodality therapies including chemotherapy, immunotherapy, and targeted agents; (3) radiation dose, schedule, and treatment volume; and (4) supportive care for patients with CEC. Ongoing trials continue to improve outcomes for patients with CEC.

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来源期刊
CiteScore
4.90
自引率
0.00%
发文量
130
审稿时长
4-8 weeks
期刊介绍: ​​​​​​​American Journal of Clinical Oncology is a multidisciplinary journal for cancer surgeons, radiation oncologists, medical oncologists, GYN oncologists, and pediatric oncologists. The emphasis of AJCO is on combined modality multidisciplinary loco-regional management of cancer. The journal also gives emphasis to translational research, outcome studies, and cost utility analyses, and includes opinion pieces and review articles. The editorial board includes a large number of distinguished surgeons, radiation oncologists, medical oncologists, GYN oncologists, pediatric oncologists, and others who are internationally recognized for expertise in their fields.
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