晚期大肠癌的外科治疗.pptVIP

外科在晚期肿瘤治疗中角色的演变 现代肿瘤治疗已经从单一依靠外科过渡到多学科参与的综合治疗 。外科医生应该熟悉肿瘤治疗的各种手段： 手术可以提高肿瘤治疗的局部和区域控制率； 化疗、放疗、内分泌治疗、生物基因治疗和分子靶向治疗等可进一步减少复发和死亡，提高患者生存率； 基因芯片、基因组学、蛋白质组学以及临床预后指标检测，有助于辅助治疗的选择和判断预后，也为肿瘤的分子研究提供了更直观、更精确的工具。 晚期大肠癌的化疗 ????????????????????????????????????????????????? ????????????????????????????????????????????????? ????????? ????????? ?????????????????????????????????????????? Lin M, Gu J, Eng C, Ellis LM, Hildebrandt MA, Lin J, Huang M, Calin GA, Wang D, Dubois RN, Hawk ET, Wu X.Genetic polymorphisms in MicroRNA-related genes as predictors of clinical outcomes in colorectal adenocarcinoma patients. Clin Cancer Res. 2012 15;18(14):3982-91. (SCI 7.742) Lin M, Eng C, Hawk ET, Huang M, Lin J, Gu J, Ellis LM, Wu X. Identification of polymorphisms in ultraconserved elements associated with clinical outcomes in locally advanced colorectal adenocarcinoma. Cancer. 2012 15;118(24):6188-98. (SCI 4.771) Lin M, Eng C, Hawk ET, Huang M, Greisinger AJ, Gu J, Ellis LM, Wu X, Lin J. Genetic variants within ultraconserved elements and susceptibility to right- and left-sided colorectal adenocarcinoma. Carcinogenesis. 2012;33(4):841-7. (SCI 5.702) Lin M, Stewart DJ, Spitz MR, Hildebrandt MA, Lu C, Lin J, Gu J, Huang M, Lippman SM, Wu X.Genetic variations in the transforming growth factor-beta pathway as predictors of survival in advanced non-small cell lung cancer. Carcinogenesis. 2011;32(7):1050-6. (SCI 5.702) Macedo LT, da Costa Lima AB, Sasse AD. Addition of bevacizumab to first-line chemotherapy in advanced colorectal cancer: a systematic review and meta-analysis, with emphasis on chemotherapy subgroups.BMC Cancer. 2012 12:89. Bevacizumab in colorectal cancer was studied initially in the metastatic setting, and was approved by US FDA in 2004, based on a survival benefit noted in the AVF2107 trial with irinotecan, 5-fluorouracil and leucovorin (IFL) regimen. The increment in OS occurred only for irinotecan-based regimens (HR = 0.78; 95% CI: 0.68-0.89; P = 0.0002) and no oxaliplatinba