直肠癌新辅助治疗后等待观察策略中国专家共识(2024 版)
Chinese expert consensus on the watch and wait strategy in rectal cancer patients after neoadjuvant treatment(2024 version)
中国直肠癌新辅助治疗后待观察数据库研究协作组 中华医学会外科学分会结直肠外科学组 中国医师协会结直肠肿瘤医师专业委员会 中国抗癌协会大肠癌专业委员会 中国医师协会外科医师分会结直肠医师工作组 武爱文 张忠涛 王锡山
摘要
近年国内外数据均证实,对新辅助治疗后达到临床完全缓解(cCR)的患者采用等待观察策略,具有很好的安全性和有效性.等待观察及部分患者采取的局部切除可实现患者器官保留,提高生活质量.自《直肠癌新辅助治疗后等待观察策略专家共识(2020版)》发布以来,在直肠癌治疗领域引起了医务人员和患者的广泛关注.近年来,直肠癌新辅助治疗后cCR比例进一步提高.虽然等待观察策略相关数据在逐步积累,但实施过程中在终点指标、风险获益、适用人群、评效标准和时机、随访和补救方法以及疗效提高策略等方面,仍存在不同的意见.这与考量的角度、实践经验以及研究证据等有关,将对等待观察策略的稳步推进有所影响.鉴于此,中国直肠癌新辅助治疗后等待观察数据库研究协作组联合中华医学会外科学分会结直肠外科学组、中国医师协会结直肠肿瘤医师专业委员会、中国抗癌协会大肠癌专业委员会和中国医师协会外科医师分会结直肠医师工作组及相关专家,在2020版共识基础上,根据列出的直肠癌等待观察和器官保留实践中的关键问题,通过文献证据、循证医学证据级别和专家意见,讨论更新形成了 2024版共识,为未来此项工作的开展提供思路和借鉴.
Abstract
In recent years,domestic and foreign data have demonstrated that the watch and wait strategy has good safety and efficacy for patients who achieve clinical complete response(cCR)after neoadjuvant therapy.Watch and wait strategy and local resection in selective patients can achieve organ preservation and improve the quality of life.Since the release of the Expert Consensus on Watch and Wait Strategy Following Neoadjuvant Therapy for Rectal Cancer(2020 version),it has attracted widespread attention from medical professionals and patients in the field of rectal cancer treatment.In recent years,the proportion of cCR after neoadjuvant therapy has further increased,and the relevant data of observation strategy has gradually accumulated.However,there are still different opinions on issues such as outcome parameters,risks and benefits,eligible population,re-evaluation criteria and timing,follow-up and salvage methods,and strategies to improve efficacy.Though it can be explained by the various viewpoints,experiences,and evidences,it objectively hinders the development of watch and wait strategy.Therefore,the Chinese Watch and Wait Database Research Collaboration Group(CWWD),together with Chinese Society of Colorectal Surgery,Chinese Medical Association;Colorectal Cancer Physician Specialty Committee,Chinese Medical Doctor Association;Colorectal Cancer Committee,Chinese Anti-Cancer Association;Colorectal Surgeon Working Group,Medical Doctor Association and relevant experts has updated consensus into the 2024 version.This consensus lists the key issues in the practice of watch and wait for rectal cancer,marks the level of evidence and expert opinions through literature review and expert opinion,and exposes the unresolved problems to provide thoughts and solutions for future work in this area.
关键词
直肠肿瘤/新辅助治疗/临床完全缓解/病理完全缓解/等待观察策略/局部切除/器官保留Key words
Rectal neoplasms/Neoadjuvant therapy/Clinical complete response/Pathological complete response/Watch and wait strategy/Local resection/Organ preservation引用本文复制引用
出版年
2024
NETL
NSTL
万方数据