Slovenske smernice sistemskega zdravljenja pljučnega raka 2017
Rak pljuč je najbolj pogost rak (če upoštevamo nemelanocitni rak kože) in smrt zaradi raka pljuč je najbolj pogost vzrok smrti zaradi raka na svetu. V Sloveniji je po pogostosti na 4. Mestu in najbolj pogost vzrok smrti zaradi raka. Slabo preživetje bolnikov z rakom pljuč (5 letno srednje preživetje je okoli 12 %) v preteklosti se z uporabo novih sistemskih zdravljen v zadnjem času izboljšuje. Sistemsko zdravljenje je pomemeben del zdravljenja raka pljuč v vseh stadijih bolezni in pri vseh patohistoloških podtipih. Sistemsko zdravljenje na osnovi platine po operaciji v sklopu adjuvantnega zdravljenja se priporoča pri večini bolnikov. Kemoterapija se uporabija sočasno sz radioterapijo pri lokalno napredovali bolezni. Sistemsko zdravljenje je osnova zdravljenja razširjene bolezni. Vrsta sistemskega zdravljnja je odvisna od patohistološkega podtipa, molekularne analize, starosti, splošnega stanja zmogljivosti, sočasnih obolenj in bolnikovih želja. Sistemsko terapijo naj bi prejeli vsi bolniki z razširjeno boleznijo s PS 0-2. Zaželjeno je, da se način zdravlejnja določi na multidisciplinarnem konziliju, izvaja pa specialist internist onkolog, z znanjem in izkušnjami glede sistemske terapije. Slovenske smernice obravnave pljučnega raka so bile zadnjič objavljene leta 2006. V pripravi so nove celostne smernice obravnave raka pljuč v Sloveniji. V članku predstavljamo posodobljenje smernice sistemskega zdravljenja, ki so plod sodelovanja strokovnjakov treh ustanov, ki se ukvarjajo s sistemskim zdravljenjem raka pljuč v Sloveniji: Onkološki inštitut Ljubljana, Univerzitetna klinika Golnik in Univerzitetni klinični center Maribor.
Primary lung cancer is the most common malignancy after non-melanocytic skin cancer, and deaths from lung cancer exceed those from any other malignancy worldwide. In Slovenia, it is the fourth most common cancer in males and in females, and the leading cause of death due to cancer. The historically poor survival rates of lung cancer patients (5-year relative survival of approx. 12 %) are improving, mainly due to the introduction of novel systemic therapies in the treatment algorithms. Systemic treatment is an important part of treatment in all stages of the disease as well as in all pathohistological subtypes of lung cancer. In operable disease, adjuvant systemic therapy with platinum- based schemas is recommended for a vast majority of patients. In locoregional disease, chemotherapy is used as concomitant with radiotherapy. Systemic treatment is the cornerstone of treatment in metastatic disease. The treatment strategy should take into account factors like histology, molecular pathology, age, PS, co-morbidities and the patient’s preferences. Systemic therapy should be considered in all stage IV patients with PS 0-2. Treatment decisions should ideally be discussed within a multidisciplinary tumor board, while the systemic treatment has to be performed by a specialist highly educated and skilled in systemic treatment of cancer. Slovenian guidelines for diagnosis, treatment and follow up were last published in 2006. In near future, a new, updated version will be published. Hereby, we only present the updated guidelines for systemic treatment. These guidelines were developed in a collaboration of the specialists from three institutions: Institute of Oncology Ljubljana, University Clinic Golnik, and University Clinical Centre Maribor.
by Authors
2017
2017-12-13 11:40:09
1060
rak pljuč, sistemsko zdravljenje, smernice
lung cancer, systemic treatment, guidelines
Mojca
Unk
70
Katja
Mohorčič
70
Ilonka
Osrajnik
70
Tanja
Čufer
70
UDK
4
616.2
ISSN pri članku
9
1408-1741
COBISS_ID
3
2714235
OceCobissID
13
65324032
RAZ_Unk_Mojca_i2017.pdf
232798
Predstavitvena datoteka
2017-12-13 11:41:33