Postoperative adjuvant therapy for completely resected early-stage non-small cell lung cancer.
Postoperative adjuvant therapy for completely resected early-stage non-small cell lung cancer.
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DOI：
10.1007/s10147-005-0493-x
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发表时间：
2005-06-01
影响因子：
3.3
通讯作者：
Hamada, Chikuma
中科院分区：
文献类型：
--
作者：
Kato, Harubumi;Tsuboi, Masahiro;Hamada, Chikuma
到2002年为止，关于完全切除的非小细胞肺癌的辅助治疗的共识如下。(1)根据Meta分析和以往的临床试验，术后辅助化疗没有显著影响。(2)在大规模前瞻性临床试验中，验证性研究是必要的。然而，自ASCO2003年以来，最近的大型试验为术后辅助化疗的临床实践带来了划时代的变化。证实了UFT在N0患者中的有效性。完全切除的I期非小细胞肺癌患者，特别是T2N0腺癌，将受益于UFT辅助化疗。1995年国际佐剂肺试验(IALT)的结果证实了Meta分析的结论。此外，JBR10和癌症与白血病B组(CALGB)9633的研究也证实了IALT阳性结果，即对完全切除的非小细胞肺癌术后以铂为基础的化疗有好处。对于病理分期从IB到II、完全切除的非小细胞肺癌的辅助化疗是基于临床试验的标准治疗。UFT在日本为IB提供了最有力的证据。也推荐使用第三代抗癌药的铂双联化疗。早期非小细胞肺癌完全切除后，应将辅助化疗作为标准护理。然而，在日本，没有证据表明以铂为基础的方案辅助化疗的可行性和有效性。在这种治疗中，应该有必要进行谨慎的管理。
Consensus on adjuvant therapy for completely resected non-small cell lung cancer until 2002 was as follows. (1) There was no significant impact of postoperative adjuvant chemotherapy based on meta-analysis and previous clinical trials. (2) Confirmatory studies are necessary in large-scale prospective clinical trials. However, recent mega trials have introduced epoch-making changes for postoperative adjuvant chemotherapy in clinical practice since ASCO 2003. The effectiveness of UFT in N0 patients was confirmed. Patients with completely resected stage I non-small cell lung cancer, especially T2N0 adenocarcinoma, will benefit from adjuvant chemotherapy with UFT. The results of the International Adjuvant Lung Trial (IALT) have confirmed the meta-analysis in 1995. Also, both the JBR10 and Cancer and Leukemia Group B (CALGB) 9633 studies have also confirmed positive IALT results of the benefit for postoperative platinum-based chemotherapy in completely resected non-small cell lung cancer. Adjuvant chemotherapy for pathological stage IB to II, completely resected non-small cell lung cancer is standard care based on clinical trials. UFT showed the strongest evidence for IB in Japan. Platinum doublet chemotherapy with third-generation anticancer agents is also recommended. Adjuvant chemotherapy should be offered as standard care to patients after completely resected early stage non-small cell lung cancer. However, there is no evidence of the feasibility and efficacy for adjuvant chemotherapy with the platinum-based regimen in Japan. Careful management should be necessary in such treatment.