NCCN临床实践指南_睾丸癌(2019.V1)英文版

1、NCCN Clinical Practice Guidelines in Oncology NCCN Guidelines Continue Version 1 2019 10 22 18 National Comprehensive Cancer Network Inc 2018 All rights reserved The NCCN Guidelines Testicular Cancer Version 1 2019 October 22 2018 NCCN org NCCN Guidelines Version 1 2019 Testicular Cancer NCCN Guidelines Index Table of Contents Discussion Version 1 2019 10 22 18 National Comprehensive Cancer Network Inc 2018 All rights reserved The NCCN Guidelines Continue NCCN Guidelines Panel Disclosures Medica

2、l oncology Hematology Hematology oncology Radiotherapy Radiation oncology Internal medicine Urology Pathology Discussion writing committee member Timothy Gilligan MD Chair Case Comprehensive Cancer Center University Hospitals Seidman Cancer Center and Cleveland Clinic Taussig Cancer Institute Daniel W Lin MD Vice Chair Fred Hutchinson Cancer Research Center Seattle Cancer Care Alliance Rahul Aggarwal MD UCSF Helen Diller Family Comprehensive Cancer Center David Chism MD MS Vanderbilt Ingram Canc

3、er Center Nicholas Cost MD University of Colorado Cancer Center Ithaar H Derweesh MD UC San Diego Moores Cancer Center Hamid Emamekhoo MD University of Wisconsin Carbone Cancer Center Darren R Feldman MD Memorial Sloan Kettering Cancer Center Daniel M Geynisman MD Fox Chase Cancer Center Steven L Hancock MD Stanford Cancer Institute Chad LaGrange MD Fred Postchemotherapy Management TEST 14 Third Line Therapy TEST 15 Follow up for Seminoma TEST A Follow up for Nonseminoma TEST B Principles of Rad

4、iotherapy for Pure Testicular Seminoma TEST C Risk Classification for Advanced Disease TEST D Primary Chemotherapy Regimens for Germ Cell Tumors TEST E Second Line Chemotherapy Regimens for Metastatic Germ Cell Tumors TEST F Third Line Chemotherapy Regimens for Metastatic Germ Cell Tumors TEST G Principles of Surgery for Germ Cell Tumors TEST H Principles of Imaging TEST I Staging ST 1 The NCCN Guidelines are a statement of evidence and consensus of the authors regarding their views of currently

5、 accepted approaches to treatment Any clinician seeking to apply or consult the NCCN Guidelines is expected to use independent medical judgment in the context of individual clinical circumstances to determine any patient s care or treatment The National Comprehensive Cancer Network NCCN makes no representations or warranties of any kind regarding their content use or application and disclaims any responsibility for their application or use in any way The NCCN Guidelines are copyrighted by Nation

6、al Comprehensive Cancer Network All rights reserved The NCCN Guidelines and the illustrations herein may not be reproduced in any form without the express written permission of NCCN 2018 Clinical Trials NCCN believes that the best management for any patient with cancer is in a clinical trial Participation in clinical trials is especially encouraged To find clinical trials online at NCCN Member Institutions click here nccn org clinical trials clinicians aspx NCCN Categories of Evidence and Consen

7、sus All recommendations are category 2A unless otherwise indicated See NCCN Categories of Evidence and Consensus NCCN Categories of Preference All recommendations are considered appropriate See NCCN Categories of Preference Printed by Maria Chen on 10 22 2018 9 14 44 PM For personal use only Not approved for distribution Copyright 2018 National Comprehensive Cancer Network Inc All Rights Reserved NCCN Guidelines Version 1 2019 Testicular Cancer NCCN Guidelines Index Table of Contents Discussion

8、Version 1 2019 10 22 18 National Comprehensive Cancer Network Inc 2018 All rights reserved The NCCN Guidelines UPDATES Continued Updates in Version 1 2019 of the NCCN Guidelines for Testicular Cancer from Version 2 2018 include Global Changes The NCCN Categories of Preference have been applied to all of the suggested treatment regimens Stage IA and IB for Nonseminoma were changed to Stage I without risk factors and Stage I with risk factors respectively TEST 2 Footnote e revised If AFP elevated

9、positive treat as nonseminoma Footnote j See Principles of Imaging TEST I was added Footnote removed The panel recommends using the AJCC Staging 7th edition for subclassifying and making treatment decisions about stage I tumors See ST 1 and ST 2 also for TEST 3 TEST 6 TEST 7 TEST 3 Category 1 was removed from Surveillance for pT1 pT3 tumors Footnote l revised Recommend chest abdomen pelvic CT scan and chest x ray or CT scan within the 4 weeks prior to the initiation of chemotherapy to confirm st

10、aging even if scan was done previously See Principles of Imaging TEST I also for TEST 7 TEST 11 Footnote m is new TEST 4 Footnote u revised Intermediate risk in seminoma is based on metastases to organs other than the lungs stage IIIC Stage IIIB does not apply to pure seminomas Patients with elevated AFP have nonseminomas and in patients with a serum bHCG above 1000 IU L consider the possibility of a NSGCT and re review surgical specimen with pathology and consider discussion with a high volume

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