2010_直肠癌.pdf

格式: pdf 页数: 68 文件大小: 6MB 侵权/举报
2010_直肠癌.pdf

2010_直肠癌.pdf

格式: pdf 页数: 68 文件大小: 6MB
2010_直肠癌.pdf Copyright © National Comprehensive Cancer Network 2010. All rights reserved. “NCCN”, the NCCN logo, and “National Comprehensive Cancer Network” are registered trademarks of the National Comprehensive Cancer Network. The Chinese edition of NCCN Clinical Practice Guidelines in Oncology-Rectal Cancer Guideline 2010 is the Chinese adapted version of NCCN Clinical Practice Guidelines in Oncology-Rectal Cancer Guideline, V.2.2010 as permitted and endorsed by NCCN. It is the collaborative outcome of the National Comprehensive Cancer Network and Chinese key opinion leaders of the field. The original guideline and Chinese edition are both available at: http://www.nccn.org. To view the most recent and complete version of the guideline, go online to www.nccn.org. These Guidelines and illustrations herein may not be reproduced in any form for any purpose without the express written permission of the NCCN. These Guidelines are a work in progress that will be refined as often as new significant data becomes available. The NCCN Guidelines are a statement of consensus of its authors regarding their views of currently accepted approaches to treatment. Any clinician seeking to apply or consult any NCCN guideline is expected to use independent medical judgment in the context of individual clinical circumstance to determine any patient's care or treatment. The National Comprehensive Cancer Network makes no warranties of any kind whatsoever regarding their content, use or application and disclaims any responsibility for their application or use in any way. This publication should not be used for commercial purpose. It is provided for free to Chinese medical professions with the support of the unrestrictive educational grant of Shanghai Roche Pharmaceuticals Ltd. which exerts no influence to the formation of the Chinese edition of NCCN Clinical Practice Guidelines in Oncology- Rectal Cancer Guideline 2010. NCCN ® 肿瘤学临床实践指南(中国版)2010年 第一版 © National Comprehensive Cancer Network, Inc. All rights reserved. These guidelines and this illustration may not be reproduced in any form without the express written permission of NCCN. The Chinese edition 2010 is the collaborative outcome of the National Comprehensive Cancer Network and Chinese key opinion leaders of the field. Translated and adapted with permission and endorsement from the National Comprehensive Cancer Network. To view the most recent and complete version of this or any other guideline, visit www.nccn.org. 直肠癌 NCCN直肠癌专家组成员 肿瘤内科 放疗/肿瘤放射科 外科/肿瘤外科 病理科 血液科/血液肿瘤科 内科 胃肠科 诊断/介入放射科 编委会成员 † § ¶ ≠ ‡ Þ ¤ φ * * Paul F. Engstrom, MD/Chair † Fox Chase Cancer Center Juan Pablo Arnoletti, MD ¶ University of Alabama at Birmingham Comprehensive Cancer Center * Al B. Benson, III, MD † Robert H. Lurie Comprehensive Cancer Center of Northwestern University Jordan D. Berlin, MD † Vanderbilt-Ingram Cancer Center J. Michael Berry, MD † UCSF Helen Diller Family Comprehensive Cancer Center Yi-Jen Chen, MD, PhD § City of Hope Comprehensive Cancer Center Michael A. Choti, MD ¶ The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins Harry S. Cooper, MD ≠ Fox Chase Cancer Center Raza A. Dilawari, MD ¶ St. Jude Children's Research Hospital/ University of Tennessee Cancer Institute Dayna S. Early, MD ¤ Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine Peter C. Enzinger, MD † Dana-Farber/Brigham and Women’s Cancer Center Marwan G. Fakih, MD † Roswell Park Cancer Institute James Fleshman, Jr., MD ¶ Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine Charles Fuchs, MD † Dana-Farber/Brigham and Women’s Cancer Center Jean L. Grem, MD † UNMC Eppley Cancer Center at The Nebraska Medical Center James A. Knol, MD ¶ University of Michigan Comprehensive Cancer Center Lucille A. Leong, MD † City of Hope Comprehensive Cancer Center Edward Lin, MD † Fred Hutchinson Cancer Research Center / Seattle Cancer Care Alliance Mary F. Mulcahy, MD ‡ Robert H. Lurie Comprehensive Cancer Center of Northwestern University Eric Rohren, MD, PhD φ The University of Texas M. D. Anderson Cancer Center David P. Ryan, MD ¤ Massachusetts General Hospital Cancer Center * Leonard Saltz, MD † ‡ Þ Memorial Sloan-Kettering Cancer Center David Shibata, MD ¶ H. Lee Moffitt Cancer Center and Research Institute at the University of South Florida John M. Skibber, MD ¶ The University of Texas M. D. Anderson Cancer Center William Small, Jr., MD§ Robert H. Lurie Comprehensive Cancer Center of Northwestern University Constantinos T. Sofocleous, MD, PhD φ Memorial Sloan-Kettering Cancer Center James Thomas, MD, PhD † Arthur G. James Cancer Hospital & Richard J. Solove Research Institute at The Ohio State University Alan P. Venook, MD † ‡ UCSF Helen Diller Family Comprehensive Cancer Center Christopher Willett, MD § Duke Comprehensive Cancer Center NCCN ®直肠癌 肿瘤学临床实践指南(中国版)2010年 第一版 © National Comprehensive Cancer Network, Inc. All rights reserved. These guidelines and this illustration may not be reproduced in any form without the express written permission of NCCN. The Chinese edition 2010 is the collaborative outcome of the National Comprehensive Cancer Network and Chinese key opinion leaders of the field. Translated and adapted with permission and endorsement from the National Comprehensive Cancer Network. To view the most recent and complete version of this or any other guideline, visit www.nccn.org. NCCN指南中国版专家 组召集人: 孙 燕 中国医学科学院北京协和医学院 肿瘤医院 NCCN代表: Alan P. Venook, MD U C S F H e l e n D i l l e r F a m i l y Comprehensive Cancer Center NCCN直肠癌临床实践指南(中国版)专家组 组长: 万德森 中山大学附属肿瘤医院 李 进 复旦大学附属肿瘤医院 执笔人(按拼音排序): 蔡三军 复旦大学附属肿瘤医院 徐瑞华 中山大学附属肿瘤医院 章 真 复旦大学附属肿瘤医院 NCCN特别鸣谢 成员(按拼音排序): 巴 一 天津医科大学附属肿瘤医院 顾 晋 北京大学临床肿瘤学院、北京肿瘤医院 管忠震 中山大学附属肿瘤医院 何友兼 中山大学附属肿瘤医院 季加孚 北京大学临床肿瘤学院、北京肿瘤医院 李晔雄 中国医学科学院北京协和医学院肿瘤医院 林 锋 广东省人民医院 刘云鹏 中国医科大学附属第一医院 秦叔逵 中国人民解放军第八一医院 沈 琳 北京大学临床肿瘤学院、北京肿瘤医院 王金万 中国医学科学院北京协和医学院肿瘤医院 王雅杰 第二军医大学附属长海医院 徐建明 中国人民解放军三○七医院 于世英 华中科技大学同济医学院附属同济医院 余子豪 中国医学科学院北京协和医学院肿瘤医院 张 力 中山大学附属肿瘤医院 张苏展 浙江大学医学院附属第二医院 郑 树 浙江大学医学院附属第二医院 NCCN ® 肿瘤学临床实践指南(中国版)2010年 第一版 © National Comprehensive Cancer Network, Inc. All rights reserved. These guidelines and this illustration may not be reproduced in any form without the express written permission of NCCN. The Chinese edition 2010 is the collaborative outcome of the National Comprehensive Cancer Network and Chinese key opinion leaders of the field. Translated and adapted with permission and endorsement from the National Comprehensive Cancer Network. To view the most recent and complete version of this or any other guideline, visit www.nccn.org. 直肠癌 目录 NCCN直肠癌专家组成员 NCCN特别鸣谢 指南更新概要 临床表现和主要治疗: ● 带蒂息肉伴浸润癌(REC-1) ● 广基息肉伴浸润癌(REC-1) ● 适合切除的直肠癌(REC-2) T1~2,N0:初始治疗和辅助治疗(REC-3) T3,N0或任何T,N1~2:初始治疗和辅助治疗(REC-4) T4和/或局部不可切除:初始治疗和辅助治疗(REC-4) 任何T,任何N,M1:转移瘤可切除的治疗和监测(REC-5) 任何T,任何N,M1:转移瘤不可切除或临床上不能耐受手术的治疗(REC-6) 监测(REC-7) 复发和检查(REC-8) 术后CEA升高(REC-8) 病理评估原则(REC-A) 手术治疗原则(REC-B) 辅助治疗原则(REC-C) 放射治疗原则(REC-D) 晚期或转移性直肠癌的化疗(REC-E) 随诊原则(REC-F) 临床试验:NCCN认为任何肿瘤患者都可以在临床试验中得到最佳 处理,因此特别鼓励肿瘤患者参加临床试验。 NCCN对证据和共识的分类: 除非特别指出,NCCN对所有建议均达成2A类共识。 见NCCN对证据和共识的分类 声明: 本指南中标注“※”处为中国专家根据国内实际情况进行明显改动 或补充之处,内容有别于英文版,参考时请注意。 作为共识,NCCN肿瘤学临床实践指南反映了作者们对目前认可的治疗方法的观点,欲参考或应用这些指南的临床医师应根据个人具体的临床情况做出独立的医疗判断,以决定患者所需的护理和治疗。任何寻求使用这些指南的 病人或非医生人员应咨询医生关于它们的合理应用。 NCCN肿瘤学临床实践指南编译力求精确表达反映原版英文指南。NCCN不保证指南编译的有效性,也不承认任何无限制性的担保、表达及暗示。NCCN不担保指南编译或指南本身的精确性和完整性。NCCN不保证或担保或陈 述指南的应用及应用结果。NCCN及其成员不对涉及指南无限制性应用的任何偶然的、间接的、特殊的、惩罚性或作为结果的补偿费承担任何责任。 分期 讨论 参考文献 ...