适当的治疗间隔不会影响癌症患者的预后。

Holistic integrative oncology Pub Date : 2022-01-01 Epub Date: 2022-07-05 DOI:10.1007/s44178-022-00010-z
Wei Gao, Jiaxing Wang, Sifei Yin, Cuizhi Geng, Binghe Xu
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引用次数: 1

摘要

目的:重大突发公共卫生事件可能导致癌症患者在诊断和治疗的每个阶段的治疗延迟或改变。这些延误和治疗变化对癌症患者的治疗结果有多大影响?方法:总结近三十年来的相关研究,从就医、新辅助治疗、手术、术后化疗、放疗和靶向治疗等方面探讨延迟治疗对癌症患者预后的影响。结果:延迟寻求医疗帮助≥12 周影响预后。诊断后4周内的手术治疗不会影响患者的预后。在确诊后8周内开始新辅助化疗,在新辅助化疗完成后8周或更短时间内接受手术治疗,以及在手术后8周接受放疗,均不影响患者预后。延迟化疗不会增加癌症腔A型乳腺癌患者的复发风险。使用曲妥珠单抗治疗的luminal B、三阴性或HER2阳性乳腺癌症患者术后化疗开始每延迟4周,将对预后产生不利影响。HER2阳性乳腺癌症患者的靶向治疗延迟不应超过60 手术后几天或4天 诊断后数月。术后8周内的放射治疗并没有增加未接受辅助化疗的早期癌症患者的复发风险。结论:不同的治疗具有不同的时间敏感性,仔细评估和管理这些延迟将有助于最大限度地减少对患者的负面影响。
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An appropriate treatment interval does not affect the prognosis of patients with breast Cancer.

Purpose: Major public health emergencies may lead to delays or alterations in the treatment of patients with breast cancer at each stage of diagnosis and treatment. How much do these delays and treatment changes affect treatment outcomes in patients with breast cancer?

Methods: This review summarized relevant research in the past three decades and identified the effect of delayed treatment on the prognosis of patients with breast cancer in terms of seeking medical treatment, neoadjuvant treatment, surgery, postoperative chemotherapy, radiotherapy, and targeted therapies.

Results: Delay in seeking medical help for ≥12 weeks affected the prognosis. Surgical treatment within 4 weeks of diagnosis did not affect patient prognosis. Starting neoadjuvant chemotherapy within 8 weeks after diagnosis, receiving surgical treatment at 8 weeks or less after the completion of neoadjuvant chemotherapy, and receiving radiotherapy 8 weeks after surgery did not affect patient prognosis. Delayed chemotherapy did not increase the risk of relapse in patients with luminal A breast cancer. Every 4 weeks of delay in the start of postoperative chemotherapy in patients with luminal B, triple-negative, or HER2-positive breast cancer treated with trastuzumab will adversely affect the prognosis. Targeted treatment delays in patients with HER2-positive breast cancer should not exceed 60 days after surgery or 4 months after diagnosis. Radiotherapy within 8 weeks after surgery did not increase the risk of recurrence in patients with early breast cancer who were not undergoing adjuvant chemotherapy.

Conclusion: Different treatments have different time sensitivities, and the careful evaluation and management of these delays will be helpful in minimizing the negative effects on patients.

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