A preoperative alternating chemotherapy and radiotherapy program for patients with stage IIIA (N2) non-small cell lung cancer.
A preoperative alternating chemotherapy and radiotherapy program for patients with stage IIIA (N2) non-small cell lung cancer.
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针对 IIIA (N2) 期非小细胞肺癌患者的术前交替化疗和放疗方案。
DOI：
10.1016/s0169-5002(00)00137-9
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发表时间：
2000
期刊：
影响因子：
5.3
通讯作者：
K. Shirouzu
中科院分区：
文献类型：
--
作者：
S. Takamori;T. Rikimaru;A. Hayashi;K. Tayama;M. Mitsuoka;K. Fujimoto;M. Horiuchi;N. Hayabuchi;K. Oizumi;K. Shirouzu
本研究的目的是评估术前交替化疗和放疗方案的可行性和毒性，然后手术治疗IIIA期非小细胞肺癌（NSCLC）。还评价了肿瘤缓解、切除率、肿瘤/淋巴结降级和生存率。在我们的标准上，使用常规磁共振成像（MRI）和短反转时间反转恢复（STIR）技术（STIR-MRI）诊断纵隔淋巴结转移的阳性预测值（PPV）为81%。符合条件的患者具有临床N2病变（IIIA期），世界卫生组织（WHO）体能状态评分为0-2。治疗方案包括两个疗程的术前顺铂、长春地辛和异环磷酰胺;与放疗交替，包括两个疗程的20戈伊放疗。治疗后4周内进行手术。22例IIIA（N2）期NSCLC患者（20例男性和2例女性，年龄35-71岁）入组本研究。血液学和其他毒性在可接受范围内。2例患者因远处转移而不适合手术; 1例肾功能不全患者和1例全血细胞减少患者在治疗期间随后接受了手术。临床缓解率为50%（部分缓解11/22）。18例患者接受了再次手术，其中17例完全切除，1例开胸探查。41%的患者（17例中7例;无残留肿瘤）发生原发性肿瘤的病理完全缓解，而58%（17例中10例）为病理N 0。17例完全切除患者的中位生存期为33个月，4年生存率为33%;所有入组患者的中位生存期为30个月，4年生存率为28%。一项使用这种方法治疗IIIA期（临床N-2疾病）的随机III期研究是必要的。
The objective of the present study was to evaluate the feasibility and toxicity of a preoperative alternating chemotherapy and radiotherapy program followed by surgery in stage IIIA non-small cell lung cancer (NSCLC). The tumor response, resection rate, tumor/lymph node downstaging, and survival were also evaluated. The positive predictive value (PPV) in the diagnosis of mediastinal lymph node metastasis was 81% using conventional magnetic resonance imaging (MRI) with short inversion-time inversion recovery (STIR) technique (STIR-MRI) on our criteria. Eligible patients had clinical N2 lesions (stage IIIA) and a World Health Organization (WHO) performance status of 0–2. The treatment program consisted of two courses of preoperative cisplatin, vindesine, and ifosfamide; alternating with radiotherapy, including two courses of 20 Gy radiation. Surgery was performed within 4 weeks after the treatment. Twenty-two patients with stage IIIA (N2) NSCLC (20 men and two women, age 35–71 years) were enrolled into the study. Hematologic and other toxicities were within an acceptable range. Surgery was not indicated for two patients because of distant metastasis; one patient with renal dysfunction and one with pancytopenia during this treatment underwent surgery subsequently. The clinical response rate was 50% (partial response in 11/22). Definitive surgery was indicated for 18 patients resulting in 17 patients with complete resection and one exploratory thoracotomy. A pathologic complete response of the primary tumor occurred in 41% of the patients (seven of 17; without residual tumor), whereas 58% (ten of 17) were pathologic N0. The median survival was 33 months with an actuarial 4-year survival rate of 33% in 17 patients with complete resection and 30 months with 28% 4-year survival rate in all entered patients. A randomized phase-III study using this approach for stage IIIA (clinical N-2 disease) is warranted.
DOI：
10.1016/0360-3016(92)90888-o
发表时间：
1992-01-01
影响因子：
7
作者：
TISHLER, RB;SCHIFF, PB;HALL, EJ
通讯作者：
HALL, EJ
DOI：
10.2307/2272241
发表时间：
--
期刊：
JOURNAL OF SYMBOLIC LOGIC
影响因子：
0.57
作者：
F. Lowenthal
通讯作者：
F. Lowenthal
影响因子：
158.5
作者：
DILLMAN, RO;SEAGREN, SL;GREEN, MR
通讯作者：
GREEN, MR