What is comprehensive oncology treatment?

When formulating a tumor treatment plan, the following objectives should be considered: 1) to kill as many tumor cells as possible that have already occurred and prevent the formation of new tumor cells to prolong the patient’s survival; 2) to minimize the negative impact on the patient due to the treatment as well as to reduce the different degrees of pain caused by the tumor to the patient and to improve the patient’s quality of life; 3) to take care of the relationship between cost and benefit at the same time. From the historical development and evolution of tumor treatment methods, it is easy to see that surgery, radiotherapy and chemotherapy constitute the three pillars of modern tumor therapeutics. Together with various minimally invasive and non-invasive therapies and biological therapies that have been widely used in the past 10 years, they have gradually formed a multidisciplinary and comprehensive treatment approach that has its own characteristics and complements each other. The so-called comprehensive tumor treatment is to apply the existing multidisciplinary effective treatments in a planned and rational manner according to the patient’s physical and mental condition, the specific location, pathological type, invasion range (disease stage) and development tendency of the tumor, combined with the changes of cellular molecular biology, in order to obtain the best treatment effect with the most suitable economic cost and to improve the patient’s survival quality to the maximum extent. The connotation of comprehensive treatment: surgery, radiotherapy, chemotherapy and biotherapy are still the main methods of treating tumors, and they complement each other. In terms of therapeutic effect, surgery and radiotherapy are local treatment methods, and the focus of treatment is naturally on localization, that is, controlling local growth and local spread, especially the metastasis of lymph nodes. Chemotherapy and biological therapy are systemic therapies, which focus more on the spread and metastasis of malignant tumors, in addition to local tumors. Biological therapies focus on improving the immune function of the body or attacking tumors at the molecular level, including cytokines, monoclonal antibodies, immunologically active cells, tumor vaccines, gene therapy, etc., which are still in the exploration stage so far but have shown attractive prospects. Various therapeutic approaches have their own advantages and disadvantages. Surgery and focal site radiation therapy are best for treating tumors at the primary site, however, systemic chemotherapy has the potential to eradicate microscopic (subclinical) metastases. On the other hand, the interaction of treatment methods is also important. After surgical resection of a large lesion, the residual tumor at other sites may be more sensitive to subsequent chemotherapy because of the stimulated proliferation; chemotherapy may have a radiosensitizing effect; and hormonal therapy can complement chemotherapy because it does not depend on cell proliferation. Therefore, only by fully considering all aspects and organically combining surgery, radiotherapy, chemotherapy and biological therapy according to the characteristics of different cases, we can develop a treatment plan for malignant tumors with the best therapeutic effect, which is the comprehensive treatment of tumors.