医学
全身疗法
背景(考古学)
离格
认知重构
肿瘤科
内科学
疾病
重症监护医学
转移
癌症
放射治疗
乳腺癌
生物
古生物学
社会心理学
心理学
作者
Rohan R. Katipally,Sean P. Pitroda,N.M. Woody,Steven J. Chmura,Ralph R. Weichselbaum
标识
DOI:10.1038/s41571-022-00655-9
摘要
Metastases remain the leading cause of cancer-related mortality. The oligometastasis hypothesis postulates that a spectrum of metastatic spread exists and that some patients with a limited burden of metastases can be cured with ablative therapy. Over the past decade, substantial advances in systemic therapies have resulted in considerable improvements in the outcomes of patients with metastatic cancers, warranting re-examination of the oligometastatic paradigm and the role of local ablative therapies within the context of the improved therapeutic responses, shifting patterns of disease recurrence and possible synergy with systemic treatments. Herein, we reframe the oligometastatic phenotype as a dynamic state for which locally ablative, metastasis-directed therapy improves clinical outcomes, including by prolonging survival and increasing cure rates. Important risk factors defining the metastatic spectrum are highlighted that inform both staging and therapy. Finally, we synthesize the literature on combining local therapies with modern systemic treatments, identifying general themes to optimally integrate ablative therapies in this context.
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