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陈 功 教授


主任医生,博士研究生导师


中山大学隶属肿瘤病院结直肠科副主任

我国临床肿瘤学会副秘书长、常务理事

亚洲临床肿瘤学联盟副秘书长

2015-2017年美国临床肿瘤学会学术委员会委员

广东省抗癌协会大肠癌专委会主任委员

2019年第三届“国之名医·精巧风仪”获得者

我国抗癌协会大肠癌专业委员会委员

CSCO结直肠癌专委会常委

CSCO结直肠癌攻略专家组秘书、执笔人

我国医生协会结直肠外科医生分会常务委员

我国研究型病院协会肿瘤MDT专委会副主任委员

世界肝胆胰协会搬运性肝癌专委会副主任委员

我国医生协会结直肠肿瘤专委会肝搬运分会副主任委员

美国临床肿瘤学会会员

欧洲肿瘤学会会员

《NCCN直肠癌攻略》中文版副主译

《中华胃肠外科杂志》《肿瘤归纳医治电子杂志》编委

《癌症》《中华医学杂志》英文版、《中华肿瘤杂志》特约审稿专家

Annals of Oncology杂志结直肠癌中文版编委

The Oncologist杂志中文版编委

《新英格兰医学杂志》中文版《医学前沿》特约述评专家及编纂委员会委员

榜首或通讯作者揭橥原创论文30余篇,SCI录入17篇,包含Dis colon rectum, J Cancer Res Clin Oncol, Ann Oncol, Int J Colorectal Dis, BMC Cancer, British J Cancer, Plos ONE,Chinese Journal of Cancer,Scientific Report、Japanese Journal of Clinical Oncology、《中华医学杂志》等。NEJM揭橥议论文章1篇。


2020年结直肠癌医治发展清点


榜首部分

围术期医治篇


1

直肠癌的术前新辅佐医治






















集体1,即肿瘤极低方位,基线时手术即或许率面对肛门括约肌功用丢失或极大损伤者,活跃饯别图2中的形式2即CNCT-TNT,首要医治政策是最大极限使肿瘤畏缩,以期到达cCR,然后走W W,或肿瘤明显畏缩后走部分切除,然后最大水平保全功用;


集体2,基线时保肛没有难度、但远处搬运危险较高者,如距肛门 5 cm中上段肿瘤但伴有EMVI+、N2、侧方淋趋承+等不良预后身分;活跃饯别图2中的形式1即INCT-TNT,首要医治政策是最大极限下降远处搬运率,耽搁生计。该形式若是INCT效果好,乃至可以考虑宽免掉后续的部分放疗,来进一步减少医治相关毒性,尤其是放疗敌手术的影响。


集体3,不存在上述两种集体特征的LARC,无需TNT,仍然实施传统“三明治”形式,防止过度医治。









2

结肠癌的术前新辅佐医治





3

结肠癌辅佐化疗发展及根据新式分子符号物的单个化抉择











4

搬运瘤弗成切除的晚期结直肠癌无症状原发灶切除的争议与一致















高龄/体质弱或其他原因导致患者无条件/不愿意接收纪律的体系全身医治者;

估量短期内会闪现梗阻等症状者,比如降-乙结肠部肿瘤,肠镜下肿物累及全周,内镜无法经由者;

肿瘤负荷明显大于搬运灶的巨块型原发灶;

全身医治后搬运瘤把握精巧,而瘤负荷仍然很重的原发灶,估量切除原发灶可以明显减少整体肿瘤负荷者;

估计后续全身医治中患者需求长期运用贝伐珠单抗,而使得原发瘤切除机遇变得难以抉择时,可以考虑在起头贝伐珠单抗医治前切除原发灶;

肿瘤内科评价后以为原发灶的存在现已/行将搅扰到全身医治的展开。


第二部分

mCRC全身医治篇


1

MSI-H型mCRC一线医治:PD-1单抗帕博利珠单抗完胜标准化疗/靶向医治






















2

MSS型mCRC免疫医治索求:仍然迷雾重重,鲜有突破




3

根据可感染靶点的末线精准医治:抗BRAF和抗HER2医治






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