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Ezofagus (Th opcije (neo KRT vs KT (studije (Sthal - POET trial, cis 5fu,…

- - - - OS loš
      - obstrukcija
        
        RT
        
        stent
      - vrste OP
      - mortalitet <10%
      - lokacija
        
        srednji, donji
      - OP (ezofagetomija)
        
        QoL, 2y loša
        
        histologija-SCC KRT, ACC OP
        
        https://www.youtube.com/watch?v=YseltvpU0xQ&t=1007s
        
        salvage kirurgija nakon primarne KRT, OS jednak vs neo KRT pa OP
        
        Marker JCO 2015
        
        https://www.youtube.com/watch?v=ljay-jB7nkY
        
        metastatski
        
        KT + OP
        
        Schmidt 123 pts- 70ACC, neo KT pa OP meta - 77 mj OS s OP
        
        FLOT 3, želudac AC, oligometa, OP bolji ishod
        
        https://www.youtube.com/watch?v=sAyK-gjzS3c
  - - - CROSS, 360 pts, 75% ACC, 0cT3, 70%N1, KT (Carbo+Tax), RT41.4Gy, HR CSS 0.43, ACC0.73, pCR 30%, 5yOS 50%
        
        https://www.youtube.com/watch?v=n6MTQSwv9lg
      - Walsh, 40Gy cis+5FU,OS poz
        
        https://www.youtube.com/watch?v=3PmVJQUCm4E
      - CALGB 9781, 50Gy cis+5FU, 5y 30% poz
      - negativne
        
        Boset
        
        Urba
        
        Francuska 9901
  - - - MAGIC, 500p, ECF 3x2, pCR0
        
        https://www.youtube.com/watch?v=70U2yybKhKg
      - Japanska
      - Francuska
      - FLOT 4 (FLOTx4 -op-FLOTx4), želudac, GEJ, 70pts, OS 35 vs 50 mj za FLOT-u, HR 0.77
        
        https://www.youtube.com/watch?v=fOK3RHZ5Jhw
      - meta analiza HR .87 SS
      - OE 2, 5FU/cisx2, 800 pts, + DFS HR0.82, SS OS HR.84
    - - Intergrup
      - POET
  - - - Sthal - POET trial, cis 5fu, kt-OP vs kt-KRT-OP, 120 pts slabo skupljanje, 3y os 30 vs 50% nss, pCR 2vs 16%
        
        https://www.youtube.com/watch?v=LDIbbs4f8bM
      - meta analiza HR.88 NSS
      - pCR 13-28%
        
        NEOSCOPE, 80pts, Ox/cape pa Ox/cape vs Carbo/pakli + RT 30Gy pa OP
        
        https://www.youtube.com/watch?v=-NBJNYWkN4E
      - neoRES, 180 pts, cis+5FU vs c/5FU RT 40Gy, krvulje jednake
    - - studije 2
        
        neo KRT pa OP vs KRT, bolja LC s OP ali nema razike u OS-u
        
        Franscuska #
        
        Njemačka
        
        Markeri vidi prethodno
        
        u tijeku
        
        Pre Sano - Nizozemska-kako izabrat za praćenje pts (PET, biopsije, CT-ovi..)
        
        https://www.youtube.com/watch?v=JDa5YTUMcJE
    - - https://www.youtube.com/watch?v=OpaAwW8Yfrs
  - - - studije
        
        Njemačka, Francuska studija- bolji OS KRT vs OP
        
        PRODIGE/ACORD 17, OS20 mj
        
        https://www.youtube.com/watch?v=uaiaJGuFo0s
        
        SCOPE 1, UZ gledali i uzimali biopsiju (rez bol 8 vs 23 mj), OS 35mj=rezultatima KRT pa OP
        
        ne responderi-treba li OP
        
        OE5 3yOS 38% vs REAL 2 3y OS 20%
        
        https://www.youtube.com/watch?v=88N7BJ1IHkE
        
        Intergroup-0123
        
        veća doza lošiji OS
        
        ECOG
        
        bolji OS KRT vs RT
      - indikacije
        
        inop
        
        medicinski
        
        tumor
        
        SCC=preopKRT
    - - RTOG 8501, 120 pts, 90% SCC, 64 Gy vs 50Gy + C/5FU (SS LR, DFS, OS- 13mj, AE)
  - - - Francuska
      - Fok
  - - - Chemoradiation followed by surgery (for patients with stage IVA disease).
      - Chemotherapy, which has provided partial responses for patients with metastatic distal esophageal adenocarcinomas.[2-4]
        
        meta
        
        2 L
        
        Irino vs bsc, OS 4 vs 2 do 4 mj
        
        Doc, OS 5.6 vs 3.6 BSC
        
        dati 2plet, atlete 3plet
      - Nd:YAG endoluminal tumor destruction or electrocoagulation.[5]
      - Endoscopic-placed stents to provide palliation of dysphagia.[6]
      - Radiation therapy with or without intraluminal intubation and dilation.
      - Intraluminal brachytherapy to provide palliation of dysphagia
- - - - 2 pristupa
        
        pro i kontra
        
        studija benefit
    - - što je
      - kod oga
      - indikacije
    - - 3
    - - konfilktini rez
      - 4 studije
    - - 4 studije
      - konfliktni rez
    - - ne
  - - - T3-adventicija
      - T4-perikar, pleura, diafragma
    - - dg laparatomija
        
        10-15 % upst
      - TT, hrana
  - - - cF-GE
      - od incizora
    - - plano
      - adeno
    - - prox vs distalni
    - - https://www.youtube.com/watch?v=2H6h95tGv90&t=6s
      - https://www.youtube.com/watch?v=q8TdlDIbp0U
  - - - gradusi 1-5
        
        OS
      - miRNA-genska analiza od II do IV-što manji skor bolji oS
        
        https://www.youtube.com/watch?v=t5jroSCBBwk&t=109s
    - - https://www.youtube.com/watch?v=Jpqt1PXWvng
- - - - Postop
        
        mono, adj, CM 577, u tijeku
        
        https://www.youtube.com/watch?v=qmO2R6yUKE4
        
        N+ipi adj, VESTIGE
        
        https://www.youtube.com/watch?v=J692Lz-x-p8
    - - Pembro, perio, +cus/5fu- u tijeku
        
        https://www.youtube.com/watch?v=PyROUH2IETM
    - - perio
        
        IT
        
        perio FLOT+Atezol- DANTE
        
        https://www.youtube.com/watch?v=Q-5DVUtSnoY
  - - - perio
        
        STO03, ECX+/- bev, više AE, OS isti
        
        https://www.youtube.com/watch?v=y4hpWTnaic0
  - - - HER
        
        u tijeku car/paklRT +/- tras - RTOG 1010
        
        https://www.youtube.com/watch?v=SEc_5vICmLY
        
        HER
        
        INOVATION, FLOT/FOLFOX +/- tras ili Tras+pert
        
        https://www.youtube.com/watch?v=Vdup9KRHcX4
        
        PETRARKA, FLOT +/- tras/pert
        
        https://www.youtube.com/watch?v=Qh_MlrKrlSk
        
        u tijeku
    - - ToGA, 11.7 vs 9 mj, HER poz
        
        https://www.youtube.com/watch?v=TxfLaEBJ83Q
  - - - cetuximab
        
        RTOG car/paklRT +/- cet=OS
        
        SAK Carbo/doc +/- cet=OS