Role of chemotherapy in patients with poor performance status and advanced non-small cell lung cancer.
Role of chemotherapy in patients with poor performance status and advanced non-small cell lung cancer.
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化疗在体力状态不佳和晚期非小细胞肺癌患者中的作用。
DOI：
10.1053/j.seminoncol.2004.10.002
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发表时间：
2004
影响因子：
4
通讯作者：
R. Lilenbaum
中科院分区：
文献类型：
--
作者：
C. Langer;R. Lilenbaum
晚期非小细胞肺癌的治疗仍然是一个重要的研究领域，关于化疗使用的许多问题仍然没有答案。现在人们认识到，化疗可以改善晚期非小细胞肺癌患者的生存并减轻疾病相关症状。然而，尚不清楚这些益处是否适用于表现不佳（PS）的患者。这些患者（东部肿瘤合作组PS2）与更适合的患者相比，预后较差，历史上，他们被排除在临床试验之外。在其他具有更广泛资格的试验中，PS2患者占研究人群的比例不到20%。这些因素导致难以确定PS2患者人群的真实结果。然而，在肿瘤学实践中，PS2人群占患者的很大一部分（高达30%至40%），并且新出现的数据表明，这些患者实际上可能从化疗中获得益处，例如延长生存期和提高生活质量。单药维诺瑞滨或紫杉醇的研究表明，与支持治疗相比，化疗能提高生存率，这在PS分层时仍然很显著。最近一项针对PS2患者的亚组分析，将卡铂和紫杉醇与单药紫杉醇进行比较，表明联合化疗是一种可行的选择，可能比单药治疗更可取。重要的是，一些分析表明，与更健康的患者相比，这一人群的毒性不一定更差。由于最佳药物或组合尚未确定，因此迫切需要新的策略和治疗方法。
The treatment of advanced non-small cell lung cancer remains an important area of research, with many questions about the use of chemotherapy still unanswered. It is now recognized that chemotherapy improves survival and alleviates disease-related symptoms in the population with advanced non-small cell lung cancer. However, it is unknown whether these benefits apply to patients with poor performance status (PS). These patients (Eastern Cooperative Oncology Group PS2) have inferior outcomes compared with more fit patients, and historically, they have been excluded from clinical trials. In other trials with broader eligibility, PS2 patients comprised fewer than 20% of the study populations. These factors have led to difficulty in ascertaining true outcomes in the PS2 patient population. However, the PS2 population accounts for a significant portion (up to 30% to 40%) of patients in oncology practice, and emerging data suggest that these patients may in fact garner benefits, such as prolonged survival and improved quality of life, from chemotherapy. Studies with single-agent vinorelbine or paclitaxel have shown improved survival with chemotherapy versus supportive care that remain significant when stratified by PS. A recent subset analysis of PS2 patients enrolled in a trial comparing carboplatin and paclitaxel with single-agent paclitaxel suggests that combination chemotherapy is a feasible option and is potentially preferable to single-agent therapy. Importantly, several analyses have shown that toxicity is not necessarily worse in this population compared with more fit patients. Because optimal agents or combinations have not been defined, novel strategies and therapeutics are urgently needed in this population.
吉西他滨加上最佳支持护理（BSC）vs BSC在无法手术的非小细胞肺癌中 - 一项随机试验，其生活质量是主要结果。英国NSCLC吉西他滨集团。非小细胞肺癌。
影响因子：
8.8
作者：
Anderson, H.;Hopwood, P.;Stephens, R. J.;Thatcher, N.;Cottier, B.;Nicholson, M.;Milroy, R.;Maughan, T. S.;Falk, S. J.;Bond, M. G.;Burt, P. A.;Connolly, C. K.;McIllmurray, M. B.;Carmichael, J.
通讯作者：
Carmichael, J.