NCCN临床实践指南_青少年和年轻成年人肿瘤(2019.V2)英文版

NCCN org NCCN Guidelines for Patients available at www nccn org patients Version 2 2019 04 12 19 2019 National Comprehensive Cancer Network NCCN All rights reserved NCCN Guidelines and this illustration may not be reproduced in any form without the express written permission of NCCN NCCN Clinical Practice Guidelines in Oncology NCCN Guidelines Adolescent and Young Adult AYA Oncology Version 2 2019 April 12 2019 Continue Peter F Coccia MD Chair Fred recommend interventions unique to the AYA population educate physicians regarding the prevalence of cancer in AYAs discuss long term consequences explain special considerations related to cancer management in AYA patients that aim to improve treatment tolerance compliance and clinical outcomes and promote participation in clinical trials Participation in clinical trials as well as enrollment on tumor banking and biologic protocols should be strongly encouraged in the AYA population NCCN Guidelines Version 2 2019 Adolescent and Young Adult AYA Oncology Version 2 2019 04 12 19 2019 National Comprehensive Cancer Network NCCN All rights reserved NCCN Guidelines and this illustration may not be reproduced in any form without the express written permission of NCCN Note All recommendations are category 2A unless otherwise indicated Clinical Trials NCCN believes that the best management of any patient with cancer is in a clinical trial Participation in clinical trials is especially encouraged NCCN Guidelines Index Table of Contents Discussion Printed by Maria Chen on 4 15 2019 11 08 50 PM For personal use only Not approved for distribution Copyright 2019 National Comprehensive Cancer Network Inc All Rights Reserved AYAO 2 cSee Age Specific SEER Incidences of Cancer by Age Group and Sex in the AYA Population 2011 2015 AYAO A dSee Definition of AYA Population AYAO 1 eThese centers provide a multidisciplinary approach involving a team of providers with expertise in AYA cancer treatment and management of specific mental health and developmental issues such as fertility education career development employment family planning pregnancy sexually transmitted diseases smoking and substance abuse SCREENING ASSESSMENT AND EVALUATION Treatment approaches will vary depending on initial diagnosisc d Strongly consider a referral for treatment at a cancer center with expertise in management of AYAs with cancer e and have access to clinical trials for AYAs particularly for pediatric cancer types Does this patient need emergency therapy within 24 hours YES NO Stabilize with appropriate interventions See Comprehensive Assessment AYAO 3 and See Psychosocial Behavioral Considerations AYAO 6 and AYAO 8 NCCN Guidelines Version 2 2019 Adolescent and Young Adult AYA Oncology Version 2 2019 04 12 19 2019 National Comprehensive Cancer Network NCCN All rights reserved NCCN Guidelines and this illustration may not be reproduced in any form without the express written permission of NCCN Note All recommendations are category 2A unless otherwise indicated Clinical Trials NCCN believes that the best management of any patient with cancer is in a clinical trial Participation in clinical trials is especially encouraged NCCN Guidelines Index Table of Contents Discussion Printed by Maria Chen on 4 15 2019 11 08 50 PM For personal use only Not approved for distribution Copyright 2019 National Comprehensive Cancer Network Inc All Rights Reserved AYAO 3 COMPREHENSIVE INITIAL ASSESSMENT Provide age appropriate information related to cancer See Online Resources for AYA Patients and Survivors AYAO E All female patients of child bearing potential must receive a pregnancy test prior to initiating therapy Discuss contraception prior to initiating therapy Discuss risks of infertility due to cancer and its therapy as well as fertility preservation See Fertility and Reproductive Endocrine Considerations AYAO 5 Psychosocial assessment See Psychosocial Behavioral Considerations Individual AYAO 6 and AYAO 7 Relationships AYAO 8 Socioeconomic Issues AYAO 9 See NCCN Guidelines for Distress Management Take a thorough family history and if appropriate recommend referral for genetic and familial risk assessment counseling based on clinical family history and histologic diagnosis Risk factors for breast cancer See NCCN Guidelines for Genetic Familial High Risk Assessment Breast and Ovarian Chest irradiation Risk factors for colon cancer See NCCN Guidelines for Genetics Familial High Risk Assessment Colorectal Risk factors for sarcomas See NCCN Guidelines for Soft Tissue Sarcoma Risk Factors for Multiple Endocrine Neoplasms MEN See NCCN Guidelines for Neuroendocrine and Adrenal Tumors Treatment related issues Fertility endocrine Adherence to treatment See Fertility and Reproductive Endocrine Considerations AYAO 5 See Psychosocial Behavioral Considerations AYAO 6 and AYAO 7 See AYAO 4 NCCN Guidelines Version 2 2019 Adolescent and Young Adult AYA Oncology Version 2 2019 04 12 19 2019 National Comprehensive Cancer Network NCCN All r