Combined modality therapy for stage IIIA non-small cell carcinoma of the lung.

Combined modality therapy for stage IIIA non-small cell carcinoma of the lung.
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IIIA 期非小细胞肺癌的联合治疗。

DOI:
10.1016/s0959-8049(05)80140-6
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发表时间:
1993
期刊:
European journal of cancer (Oxford, England : 1990)
影响因子:
--
通讯作者:
Murray,C
Murray,C
中科院分区:
--
文献类型:
--
作者:
Weitberg,AB;Yashar,J;Glicksman,AS;Posner,M;Cummings,F;Browne,M;Clark,J;Calabresi,P;Beitz,J;Murray,C

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53例Ⅲ A期非小细胞肺癌(NSCCL)患者接受综合治疗,包括放疗(55.8戈伊)和化疗(顺铂25 mg/m2,持续静脉滴注4 d,足叶乙甙100 mg/m2,第2、4 d,每周期1次),随后手术和辅助化疗。在53例可评价患者中,47例在诱导治疗后获得临床缓解(9例完全缓解,38例部分缓解),缓解率为89%。47例患者在诱导治疗后可手术切除,但8例患者拒绝手术,6例患者因肺功能差(医学禁忌症)不适合手术。33例患者接受开胸手术,6例患者在技术上无法切除。因此,27例患者完成了完整的手术切除。所有治疗后,28例患者获得完全缓解(53%),19例患者获得部分缓解(36%)。毒性轻微。在最长75个月(中位数28个月)的随访中,整个组的中位生存期为24个月。切除患者的中位生存率尚未达到;其6年生存率为55%。未切除的患者平均存活时间为11个月。这种多模式方案耐受性良好,诱导了高反应和切除率,并在切除患者中提高了生存率。
53 patients with stage IIIA non-small cell carcinoma of the lung (NSCCL) were treated with multimodality therapy consisting of induction radiotherapy (55.8 Gy) and two cycles of concurrent chemotherapy with cisplatin, 25 mg/m2for 4 days by continuous infusion and bolus etoposide, 100 mg/m2on days 2 and 4 of each cycle followed by surgery and adjuvant chemotherapy. Of 53 evaluable patients, 47 achieved clinical responses (9 complete response, 38 partial response) after induction therapy for a response rate of 89%. 47 patients were resectable after induction therapy, but 8 patients refused surgery and 6 patients were not eligible for surgery based on poor pulmonary function (medical contraindications). 33 patients underwent thoracotomy and in 6 patients, resection was technically unfeasible. Thus complete surgical resection was accomplished in 27 patients. After all therapy, 28 patients achieved a complete response (53%) and 19 patients a partial response (36%). Toxicities were mild. At a maximum of 75 months (median, 28 months) of follow-up, the median survival of the entire group is 24 months. The median survival of resected patients has not been reached; their 6-year survival rate is 55%. Unresected patients survived for a median of 11 months. This multimodality regimen is well-tolerated, induces a high response and resectability rate and prolongs survival in resected patients.
针对局部 III 期非小细胞肺癌,同时进行顺铂氟尿嘧啶输注和放疗,然后进行手术切除。
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