Appropriatezza diagnostico-terapeutica in oncologia - Quaderni del ...

Ministero della Salute
necessitare di tali tecnologie per un ottimale
trattamento.
Organizzazione dell’Ambulatorio di Prime Visite
e della visita di comunicazione del percorso
diagnostico-terapeutico, pazienti sintomatici
• Frequenza: ≥ 1 a settimana.
• Tempi di attesa: non superiori a 10 giorni lavorativi
dal momento della richiesta.
• Presenze: Chirurgo, Radiologo, Oncologo Medico,
Radioterapista, Infermiere professionale.
• Obiettivo: valutazione clinica e pianificazione
dell’iter diagnostico e nuovo appuntamento
per diagnosi conclusiva e terapia indicata.
• Comunicazione della diagnosi: entro 15 giorni
lavorativi.
I tempi di attesa prima dell’intervento chirurgico o
prima dell’inizio del trattamento radiante preoperatorio
non dovranno essere superiori a 3-4 settimane.
Bibliografia
Consensus Conference. Adjuvant therapy for patients
with colon and rectal cancer. JAMA 1990: 264: 1444-50
André T, Boni C, Mounedji-Boudiaf L, et al. Oxaliplatin,
fluorouracil, and leucovorin as adjuvant treatment
for colon cancer. N Engl J Med 2004; 350: 2343-51
André T, Colin P, Louvet C, et al. Semimonthly versus
monthly regimen of fluorouracil and leucovorin administered
for 24 or 36 weeks as adjuvant therapy in
stage II and III colon cancer: Results of a randomized
trial. J Clin Oncol 2003; 21: 2896-903
Andreoni B, Chiappa A, Bertani E, et al. Surgical outcomes
for colon and rectal cancer over a decade (result
from a consecutive monocentric experience in 902
unselected patients). World J Surg Oncol 2007; 5: 73
Beets-Tan RG, Beets GL, Vliegen RF, et al. Accuracy of
magnetic resonance imaging in prediction of tumourfree
resection margin in rectal cancer surgery. Lancet
2001; 357: 497-504
Cahill RA, Leroy J, Marescaux J. Localized resection
for colon cancer. Surg Oncol 2009; 18: 334-42
Chaparro M, Gisbert JP, del Campo L, et al. Accuracy
of Computed Tomographic Colonography for the detection
of polyps and colorectal tumors: a systematic
review and meta-analysis. Digestion 2009; 80: 1-17
Colon and rectum. In: American Joint Committee on
Cancer. AJCC Cancer Staging Manual. 7th ed. New
York, NY: Springer, 2002, pp. 143-64
Cunningham D, Humblet Y, Siena S, et al. Cetuximab
monotherapy and cetuximab plus irinotecan in irinotecan-refractory
metastatic colorectal cancer. N Engl J
Med 2004; 351: 337-45
de Gramont A, Figer A, Seymour M, et al. Leucovorin
and fluorouracil with or without oxaliplatin as first-line
treatment in advanced colorectal cancer. J Clin Oncol
2000; 18: 2938-47
Di Costanzo F, Sobrero A, Gasperoni S, et al. Adjuvant
chemotherapy in the treatment of colon cancer: randomised
multicenter trial of the Italian Intergroup of
Adjuvant Chemotherapy in Colon Cancer (INTACC).
Ann Oncol 2003; 14: 1365-73
Folprecht G, Lutz MP, Schoffski P, et al. Cetuximab
and irinotecan/5-fluorouracil/folinic acid is a safe combination
for the first-line treatment of patients with
epidermal growth factor receptor expressing metastatic
colorectal carcinoma. Ann Oncol 2006; 17: 450-6
Goldberg RM, Morton RF, Sargent DJ, et al. N9741:
oxaliplatin (Oxal) or CPT11 + 5-fluoruracil (5FU)/leucovorin
(LV) or oxal + CPT11 in advanced colorectal
cancer (CRC)—Updated efficacy and quality of life
(QOL) data from an intergroup study. Proc Am Soc
Clin Oncol 2003; 22: 252a (abstract 1009)
Goldberg RM, Sargent DJ, Morton RF, et al. A randomized
controlled trial of fluorouracil plus leucovorin,
irinotecan, and oxaliplatin combinations in patients with
previously untreated metastatic colorectal cancer. J Clin
Oncol 2004; 22: 23-30
Goldberg RM, Sargent DJ, Morton RF, et al. Randomized
controlled trial of reduced-dose bolus fluorouracil
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