《2022 NCCN胃癌临床实践指南》更新解读  

Update and Interpretation of 2022 National Comprehensive Cancer Network Clinical Practice Guidelines for Gastric Cancer

作　　者：刘媛[1] 赵林[1] LIU Yuan;ZHAO Lin(Department of Oncology,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100730,China)

机构地区：[1]中国医学科学院北京协和医院肿瘤内科,北京100730

出　　处：《协和医学杂志》2022年第6期999-1004,共6页Medical Journal of Peking Union Medical College Hospital

摘　　要：近日,美国国立综合癌症网络发布了2022年最新版胃癌临床实践指南。该版指南不仅细化了对腹腔转移性肿瘤的评估、术后放疗的适应证以及三药联合化疗的推荐,更为重要的是首次推荐高通量测序技术用于微卫星不稳定(microsatellite instability,MSI)/错配修复(mismatch repair,MMR)状态的检测,并推荐将MSI/MMR状态检测扩大至全人群。同时,在后线治疗中新增了数种基于分子分型的新药推荐,指明了未来胃癌精准治疗的方向。本文将对新版胃癌临床实践指南,特别是其更新部分进行解读,以期为临床实践提供指导和帮助。Recently,National Comprehensive Cancer Network(NCCN)released the latest version of clinical practice guidelines for gastric cancer.In this version,evaluation of peritoneal metastasis using laparoscopy with cytology has been refined.Postoperative chemoradiation is recommended as an alternative option for patients who have received less than a D2 lymph node dissection.The use of three cytotoxic drugs in a regimen should be reserved for medically fit patients with excellent performance status and easy access to frequent toxicity evaluation.More importantly,next generation sequencing(NGS)is recommended for the first time for the detection of microsatellite instability/mismatch repair(MSI/MMR)status.In addition,the recommendation for the detection of MSI/MMR status is extended to all newly diagnosed cases.Several recently developed targeted drugs and immuno-oncology therapy are included in the recommendation for sequential treatment.Precise treatment strategy based on biomarkers will inevitably become the future direction for gastric cancer.This article aims to interpret the updates to provide reference for clinical practice.

关 键 词：胃癌 NCCN指南 指南更新 

分 类 号：R735.2[医药卫生—肿瘤] R730.5[医药卫生—临床医学]