| Liu Huang. Updates in version 2.2018 of the NCCN guidelines for esophageal and esophagogastric junction cancers. Oncol Transl Med, 2018, 4: 116-119. |
| Updates in version 2.2018 of the NCCN guidelines for esophageal and esophagogastric junction cancers |
| Received:July 06, 2018 Revised:July 06, 2018 |
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| KeyWord:Updates in version 2.2018 of the NCCN guidelines for esophageal and esophagogastric junction cancers |
| Author Name | Affiliation | E-mail | | Liu Huang | Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology | huangliu017@163.com |
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| Abstract: |
| Preferred Regimens provide by expert group were adjusted: (1) Fluorouracil and cisplatin was no longer the
Preferred Regimen for Preoperative Chemoradiation and Perioperative Chemotherapy (recommended as
the other regimens); (2) DCF modifications were no longer the Preferred Regimens for First-Line Therapy
(recommended as the other regimens); (3) Pembrolizumab (For second-line or subsequent therapy for
MSI-H or dMMR tumors) was recommended as the Preferred Regimen for Second-Line or Subsequent
Therapy; (4) Ramucirumab for adenocarcinoma (category 1 for EGJ adenocarcinoma; category 2A for
esophageal adenocarcinoma) was no longer the Preferred Regimen for Second-Line or Subsequent
Therapy. Survivors who underwent esophagectomy are at particular risk for clinically relevant long-term
health issues, especially GI-related issues, such as malnutrition, dysphagia, dumping syndrome, delayed
gastric emptying, reflux, and fatigue, which have been shown to negatively impact survivors’ quality of life.
This update proposes the following specific management and monitoring solutions for esophageal cancer
survivors: Weight monitoring and the nutritional status in patients with esophageal cancer who underwent
surgery are important. Intervention by nutrition specialists is recommended. Treatment of postoperative
complications, such as delayed gastric emptying, dumping syndrome, esophageal bile reflux, and dysphagia
should be carefully considered, and nursing advice should also be provided. In patients who previously had
hypertension, the blood pressure condition may be improved after weight loss. Therefore, blood pressure
should be monitored, and the original antihypertensive regimen adjusted as appropriate. Patients who
previously had diabetes and hyperlipidemia may also need similar adjustments. Complications caused by
chemoradiotherapy, such as radiation-induced heart injuries and chemotherapy-induced neuropathy, should
be managed. Patient’s psychological and physical states should be evaluated. Healthy lifestyle: Specific
advice on dietary habits, living habits, physical activities, smoking cessation, and alcohol abstinence is
necessary. |
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