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首页> 外文期刊>European journal of gastroenterology and hepatology >Changes in diagnostic and treatment strategies of oesophageal cancer in the period from 2001 to 2009: A survey in the Netherlands
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Changes in diagnostic and treatment strategies of oesophageal cancer in the period from 2001 to 2009: A survey in the Netherlands

机译：2001年至2009年期间食管癌诊断和治疗策略的变化：荷兰的一项调查

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Background: In 2005, national guidelines on the diagnosis, staging and treatment of oesophageal cancer were published. We investigated whether staging and treatment strategies of oesophageal cancer had changed over the last decade and indeed followed these guidelines. Materials and methods: In 2001, a questionnaire investigating staging and treatment strategies for oesophageal cancer was sent to Dutch clinicians (response rate 64%). In 2009, the same questionnaire (response rate 41%) was repeated, thus enabling comparison of staging and treatment strategies for oesophageal cancer between 2001 and 2009 and comparing this with the nationwide guidelines of 2005. Results: The advice to use endoscopic ultrasound for staging was followed by the majority of clinicians [84% in 2009 compared with 58% in 2001 (P<0.001)], whereas positron emission tomography scanning was used by almost half of clinicians (44% in 2009, not asked in 2001). There was a strong support for the use of neoadjuvant chemoradiation in 2009 (68% preferred this treatment for a young patient in good condition without metastases), whereas the Dutch guidelines did not recommend routine use of neoadjuvant treatment in 2005. Stent placement for palliation of dysphagia was reduced [from 92% in 2001 to 27% in 2009 (P<0.001)] due to an increased use of other palliative measures, including brachytherapy. An increased use of chemotherapy (19%) or chemoradiation (39%) was noticed in younger patients (<55 years) with metastatic disease. Conclusion: Major changes in staging and treatment strategies were observed in patients with oesophageal cancer over the last decade. Although these changes in staging strategies were in concordance to the guidelines introduced in 2005, treatment strategies with curative intent were more often diverse in 2009 and not following guidelines. This suggests that in a rapidly evolving field as oncology, guideline recommendations on treatment should be updated frequently to reflect state-of-the-art knowledge with implementation of results of clinical studies.
机译：背景：2005年，发布了有关食道癌诊断，分期和治疗的国家指南。我们调查了过去十年来食管癌的分期和治疗策略是否已改变，并且确实遵循了这些指南。材料和方法：2001年，向荷兰临床医生发送了一份调查表，以调查食道癌的分期和治疗策略（答复率为64％）。 2009年，重复了相同的调查问卷（答复率为41％），从而可以比较2001年至2009年食管癌的分期和治疗策略，并将其与2005年全国指南进行比较。结果：使用内镜超声进行分期的建议紧随其后的是大多数临床医生（2009年为84％，而2001年为58％（P <0.001）），而几乎一半的临床医生使用正电子发射断层扫描（2009年为44％，2001年未要求）。 2009年强烈支持使用新辅助化学放疗（68％的患者对状况良好，无转移的年轻患者更喜欢这种治疗），而荷兰指南则建议在2005年不建议常规使用新辅助化学放疗。吞咽困难的减少[从2001年的92％减少到2009年的27％（P <0.001）]，这是由于增加了使用其他姑息治疗措施，包括近距离放射治疗所致。在转移性疾病的年轻患者（<55岁）中发现化学疗法（19％）或化学放射疗法（39％）的使用增加。结论：在过去十年中，食管癌患者的分期和治疗策略发生了重大变化。尽管分期策略的这些变化与2005年引入的指南相一致，但2009年具有治愈目的的治疗策略往往更加多样化，并且未遵循指南。这表明在肿瘤学这个快速发展的领域中，应经常更新有关治疗的指南建议，以反映最新的知识以及临床研究成果的实施情况。

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