按照RECIST 1.1标准,实体瘤治疗中的完全缓解、部分缓解与疾病进展分别依据什么界定?非靶病灶与新病灶的出现如何影响总体疗效判定?
Under RECIST 1.1, how are complete response, partial response, and progressive disease defined in solid tumor therapy, and how do non-target lesions and new lesions affect the overall response assessment?
RECIST 1.1以靶病灶最长径总和相对基线的变化为核心指标:所有靶病灶消失且病理性淋巴结短径降至10毫米以下判为完全缓解,总和缩小达到或超过30%判为部分缓解。若总和较治疗过程中曾出现的最小值增加至少20%、且绝对增幅不少于5毫米,即判定为疾病进展。无论靶病灶测量结果如何,任何新病灶的出现或非靶病灶的明确恶化均直接判定为进展。
RECIST 1.1 hinges on changes in the sum of longest diameters of target lesions from baseline: disappearance of all targets with pathologic nodes shrinking below 10 mm defines complete response, while a reduction of at least 30% defines partial response. Progression requires an increase of at least 20% over the nadir sum together with an absolute gain of 5 mm or more. Regardless of target measurements, appearance of any new lesion or unequivocal worsening of non-target lesions also establishes progression.
难度 专业 · 适合 高中(15-18)
CC BY 4.0 · 已核验 · Verified 2026-11-02
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Eisenhauer EA等《实体瘤疗效评价标准(RECIST 1.1)修订版》,European Journal of Cancer 2009年45卷228页
Eisenhauer EA et al., New response evaluation criteria in solid tumours: revised RECIST guideline (version 1.1), European Journal of Cancer 2009;45:228-247
独立核验依据 · Independent verification: 核验依据 1 CROSSREF 标识 10.1016/j.ejca.2008.10.026：New response eval
#肿瘤学总论 #实体瘤疗效评价
肿瘤多学科会诊（MDT）的核心目标是什么，哪些患者应优先纳入？
What is the core goal of a tumor multidisciplinary team (MDT) conference, and which patients should be prioritized for it?
MDT 的核心目标是让外科、肿瘤内科、放疗、影像和病理在治疗前共同制定个体化方案，避免单一学科视角导致的决策偏差。优先纳入的对象包括局部晚期需转化治疗的实体瘤患者、诊断或分期存在争议的病例，以及治疗选择直接显著影响生存或器官功能的复杂病例。
The core goal of an MDT is to have surgery, medical oncology, radiation oncology, imaging, and pathology jointly design an individualized plan before treatment, avoiding the decision bias of a single-discipline view. Priority should go to patients with locally advanced solid tumors needing conversion therapy, cases with disputed diagnosis or staging, and complex cases where the treatment choice substantially affects survival or organ function.
难度 进阶 · 适合 初中(12-15)
CC BY 4.0 · 来源待核验 · Source pending review结论有争议 · Contested
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出处备注：著录含书名，但缺版次 / 出版社 / 年份中的一部分，需编辑补全后才能做独立比对。
国家卫生健康委办公厅《肿瘤多学科诊疗试点工作方案(2019—2020年)》，国卫办医函〔2019〕160号 ; 另见: NCCN Clinical Practice Guidelines in Oncology: Principles of Cancer Management
NCCN Clinical Practice Guidelines in Oncology: Principles of Cancer Management ; see also: 国家卫生健康委办公厅《肿瘤多学科诊疗试点工作方案(2019—2020年)》，国卫办医函〔2019〕160号
#肿瘤学总论 #多学科诊疗
为什么不少乳腺癌患者在根治性手术后仍需接受辅助化疗?辅助化疗的核心目的是什么?
Why do many breast cancer patients still need adjuvant chemotherapy after definitive surgery, and what is its core purpose?
手术只能切除肉眼可见的原发灶,术前可能已有微转移灶潜伏于骨髓、肝肺等远处器官。辅助化疗的目标正是清除这些亚临床病灶,从而降低复发率并提高治愈概率。是否实施需综合淋巴结转移数目、肿瘤大小与分级、激素受体及HER2状态等复发风险评估,必要时借助多基因检测工具量化获益。
Surgery excises only the visible primary tumor, while micrometastases may already lie dormant in distant sites such as bone marrow, liver, or lung at the time of operation. Adjuvant chemotherapy targets precisely these subclinical deposits, reducing recurrence rates and raising the chance of cure. Its indication is weighed against recurrence risks—nodal involvement, tumor size and grade, hormone-receptor and HER2 status—sometimes refined with multigene assays to quantify expected benefit.
难度 进阶 · 适合 初中(12-15)
CC BY 4.0 · 来源待核验 · Source pending review
来源 · Source
出处备注：著录含书名，但缺版次 / 出版社 / 年份中的一部分，需编辑补全后才能做独立比对。
早期乳腺癌试验者协作组(EBCTCG)多药化疗荟萃分析,《柳叶刀》2012年
Early Breast Cancer Trialists' Collaborative Group (EBCTCG) meta-analysis of polychemotherapy, The Lancet, 2012
#肿瘤学 #辅助化疗