Oncology Frontier: Do you think the NCCN Guidelines are suitable for Chinese patients?

　　《肿瘤瞭望》： NCCN指南是否适合中国患者？

　　Dr Carlson: The challenge of applying scientific evidence globally is enormous. There are several principles I bring to the table when considering those sorts of questions. The first is that we are much more alike than we are different across different regions of the world. There are differences - ethnic， racial， pharmacogenomics – in the way drugs are handled in the natural history of disease and we do need to recognize those and account for those whenever we can. But again， we are much more alike than we are different. NCCN has a process when our guidelines are used in parts of the world other than the United States where we work with experts in the region and go through the guidelines together to identify those places where the guidelines need to be modified because of regional differences. These may be regional differences in patients， but also regional differences in drug or resource availability. We attempt to compensate as best as we can. Remember though， that the United States is a country of immigrants and I spent most of my life practicing medicine in the San Francisco Bay area in California and I would say a quarter of my patients in that practice were of Asian ancestry， many first generation， some second generation. There is a tremendous wealth of experience in treating multiple ethnicities within the United States because of the special characteristics of our patient populations.

　　Carlson博士：寻求全球范围内都适用的科学证据面临巨大挑战。有几点需要指出：首先，世界不同地区的患者有差异，但更多的是相似。民族、种族、药物基因组学 、疾病自然史的用药有差异，我们要认识到这种差异，如有可能，指南要考虑到这些差异。但也要知道患者之间更多的是相似。患者之间有地区差异，而药物或资源可用性也有地区差异。NCCN还推出区域性修正的NCCN指南，在美国以外的地区推广NCCN指南时，我们会与该地区专家合作，根据地区差异对必要部分进行修正，尽力使NCCN指南适用该地区患者。但请记住，美国是一个移民国家，我的大部分时间在加州旧金山湾地区行医，我的1/4的患者是亚裔，多数是第一代亚裔移民，有一些二代亚裔移民。正是美国人口的特点，我才有了治疗多种族患者的医疗经验。