2016 胸腺肿瘤的诊疗:基于中国胸腺肿瘤协作组多中心回顾性研究的共识

2016-07-30 中国胸腺肿瘤协作组 中国肺癌杂志.2016,19(7):414-417.

胸腺恶性肿瘤是一组较为罕见的惰性肿瘤,具有独特的临床病理特点。从使用ChART数据库得到的一系列回顾性研究的结果,达成共识。

中文标题:

2016 胸腺肿瘤的诊疗:基于中国胸腺肿瘤协作组多中心回顾性研究的共识

发布机构:

中国胸腺肿瘤协作组

发布日期:

2016-07-30

简要介绍:

胸腺恶性肿瘤是一组较为罕见的惰性肿瘤,具有独特的临床病理特点。从使用ChART数据库得到的一系列回顾性研究的结果,达成共识。


共识主要内容为:

①所有胸腺肿瘤均为恶性,尽管从组织学和临床表现而言多数胸腺肿瘤的恶性程度相对较低。诊治胸腺肿瘤时既要避免治疗过度也要避免治疗不足。

②在制订治疗方案时,应充分考虑肿瘤的分期和组织学类型。在术前、术后决策时必须有多学科的专业人员参与。

③应尽力实现根治性切除;如肿瘤可完整切除,则可望实现最佳预后。为此,在通过影像学检查行治疗前评估时,既要注重肿瘤分期,也要充分考虑肿瘤的可完整切除性。

④对于早期肿瘤,单纯手术即可;尚无证据支持在肿瘤完整切除后行术后辅助治疗。

⑤微创手术是安全的,且在技术上可行;因此,对于早期肿瘤应尝试应用微创手术。虽然微创手术的围术期结果可优于开胸手术,但仍需开展进一步的研究以探讨其远期疗效。

⑥虽然目前尚无定论,但仍推荐行全胸腺切除术以确保实现完整切除,并降低术后复发风险。在切除肿瘤时,完整切除前纵隔脂肪组织可在伴发重症肌无力的胸腺瘤患者中实现较佳结果。

⑦重症肌无力作为胸腺恶性肿瘤的常见伴发疾病,常表现为低度恶性的组织学类型,并有助于及早发现胸腺肿瘤。在此基础上,可望实现较高的手术切除率和更佳的生存状况;不过,早期肿瘤伴发的重症肌无力本身可导致死亡率升高,由此在一定程度上可抵消上述优势。

⑧对于已处于进展期的恶性程度较高的胸腺肿瘤,有可能通过综合治疗实现较好的预后;特别是通过准确的术前分期、组织学诊断和有效的诱导治疗(以期获得降期),来增加肿瘤完整切除的机会。

⑨常规应用辅助放疗和传统化疗药物的效果一直不能令人满意。应注意选择那些复发风险高、而更有望从辅助疗法中获益的患者进行术后辅助治疗。应针对胸腺肿瘤进一步探讨更有效的治疗方式并研发新的药物。

⑩对于不能手术切除的胸腺肿瘤或临床上无法手术治疗的患者,同步化放疗有望实现更好的疾病控制并延长生存。

相关资料下载:
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    2018-10-10 LIHUIsus

    请问国内哪家医院比较权威

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    2016-10-16 扬州国信商标

    值得学习

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    2016-10-13 胸外赵凯

    受益匪浅

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    2016-08-29 靠近你

    继续关注,学习了,谢谢分享

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=348745, encodeId=d372348e45c6, content=请问国内哪家医院比较权威, beContent=null, objectType=guider, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83er92AWgRpMBkADd7ricHW17KicicqXKJwqy10Yy1B3OicBpXn7QErDibKgibiaPysBKzIIT9VteQ24SUehRg/132, createdBy=88262434409, createdName=LIHUIsus, createdTime=Wed Oct 10 09:41:43 CST 2018, time=2018-10-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=148843, encodeId=755d14884323, content=值得学习, beContent=null, objectType=guider, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://q.qlogo.cn/qqapp/1103841572/96A4B35900FD02B08C46DE33C3A06890/100, createdBy=f4011956702, createdName=扬州国信商标, createdTime=Sun Oct 16 18:07:22 CST 2016, time=2016-10-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=147914, encodeId=41e314e914da, content=受益匪浅, beContent=null, objectType=guider, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20161013/IMG57FF8C018530D5123.jpg, createdBy=56cd1965501, createdName=胸外赵凯, createdTime=Thu Oct 13 21:44:28 CST 2016, time=2016-10-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=106770, encodeId=6dd2106e70e7, content=继续关注,学习了,谢谢分享, beContent=null, objectType=guider, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=06731943211, createdName=靠近你, createdTime=Mon Aug 29 10:41:00 CST 2016, time=2016-08-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=106539, encodeId=b12310653902, content=新理念,值得重视!学习。, beContent=null, objectType=guider, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160601/IMG574E13FEE55F33222.jpg, createdBy=929c1478678, createdName=zibozhouping, createdTime=Mon Aug 29 05:50:00 CST 2016, time=2016-08-29, status=1, ipAttribution=)]
    2016-08-29 zibozhouping

    新理念,值得重视!学习。

    0