Local Cancer Recurrence: The Realities, Challenges, and Opportunities for New Therapies.
Local Cancer Recurrence: The Realities, Challenges, and Opportunities for New Therapies.
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DOI：
10.3322/caac.21498
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发表时间：
2018-11
期刊：
影响因子：
--
通讯作者：
Raut CP
中科院分区：
文献类型：
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作者：
Mahvi DA;Liu R;Grinstaff MW;Colson YL;Raut CP
局部复发对许多恶性肿瘤的长期生存和生活质量产生负面影响。对于具有孤立的、可切除的局部复发的适当风险的患者，手术是唯一潜在的治愈性治疗。然而，即使在肉眼完全切除后，局部复发的患者的肿瘤学结局仍然较差。不幸的是，这些手术往往是广泛的围手术期发病率和死亡率显着。本综述重点介绍了选定的恶性肿瘤（间皮瘤，肉瘤，肺癌，乳腺癌，直肠癌，腹膜表面恶性肿瘤），其中手术切除是一种关键的治疗方式，局部复发在整体肿瘤结局中起着重要作用，涉及生存和生活质量。对于每种类型的癌症，评估当前最先进的治疗策略及其结果。考虑到当前标准疗法的局限性，需要额外的治疗选择。新的和新兴的治疗方式，包括聚合物薄膜和纳米颗粒，被强调为预防和治疗局部复发性癌症的潜在未来解决方案。最后，我们确定了额外的临床和研究机会，并根据不同癌症局部复发的不同模式提出了未来的研究策略。
Locoregional recurrence negatively impacts both long-term survival and quality of life for a number of malignancies. For appropriate-risk patients with an isolated, resectable local recurrence, surgery represents the only potentially curative therapy. However, oncologic outcomes remain inferior for patients with locally recurrent disease even after macroscopically complete resection. Unfortunately, these operations are often extensive with significant perioperative morbidity and mortality. This review highlights selected malignancies (mesothelioma, sarcoma, lung cancer, breast cancer, rectal cancer, peritoneal surface malignancies) in which surgical resection is a key treatment modality and where local recurrence plays a significant role in overall oncologic outcome with regards to survival and quality of life. For each type of cancer, the current, state-of-the-art treatment strategies and their outcomes are assessed. The need for additional therapeutic options is presented given the limitations of the current standard therapies. New and emerging treatment modalities, including polymer films and nanoparticles, are highlighted as potential future solutions for both prevention and treatment of locally recurrent cancers. Finally, we identify additional clinical and research opportunities, and propose future research strategies based on the varying patterns of local recurrence among the different cancers.