Ung thư dạ dày, Phiên bản 2.2022, Hướng dẫn Thực hành Lâm sàng của NCCN trong Ung thư học
Tóm tắt
Ung thư dạ dày là nguyên nhân đứng thứ ba gây tử vong liên quan đến ung thư trên toàn thế giới. Hơn 95% các trường hợp ung thư dạ dày là ung thư tuyến, thường được phân loại dựa trên vị trí giải phẫu và loại mô học. Ung thư dạ dày thường có tiên lượng xấu vì thường được chẩn đoán ở giai đoạn muộn. Liệu pháp toàn thân có thể mang lại giảm triệu chứng, cải thiện sống sót và nâng cao chất lượng cuộc sống cho bệnh nhân mắc bệnh tại chỗ tiến triển hoặc di căn. Việc triển khai xét nghiệm sinh học, đặc biệt là phân tích trạng thái HER2, trạng thái không ổn định vi nhân (MSI) và sự biểu hiện của ligand chết theo chương trình 1 (PD-L1), đã có ảnh hưởng đáng kể đến thực hành lâm sàng và chăm sóc bệnh nhân. Các liệu pháp nhắm mục tiêu bao gồm trastuzumab, nivolumab và pembrolizumab đã mang lại kết quả khả quan trong các thử nghiệm lâm sàng điều trị cho bệnh nhân mắc bệnh tại chỗ tiến triển hoặc di căn. Quản lý điều trị giảm nhẹ, có thể bao gồm liệu pháp toàn thân, hóa trị xạ và/hoặc chăm sóc hỗ trợ tốt nhất, được khuyến nghị cho tất cả các bệnh nhân mắc ung thư không thể phẫu thuật hoặc đã di căn. Quản lý đa chuyên khoa là rất cần thiết cho tất cả các bệnh nhân mắc ung thư dạ dày tại chỗ. Phần lựa chọn này từ Hướng dẫn NCCN về Ung thư Dạ dày tập trung vào quản lý bệnh tại chỗ không thể phẫu thuật, tái phát hoặc di căn.
Từ khóa
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