The Management of Patients With Stage IIIA Non-Small Cell Lung Cancer With N2 Mediastinal Node Involvement
The Management of Patients With Stage IIIA Non-Small Cell Lung Cancer With N2 Mediastinal Node Involvement
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DOI：
10.6004/jnccn.2012.0062
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发表时间：
2012-05-01
影响因子：
13.4
通讯作者：
Wood, Douglas E.
中科院分区：
文献类型：
--
作者：
Martins, Renato G.;D'Amico, Thomas A.;Wood, Douglas E.
根据同侧纵隔淋巴结受累确定的IIIA期非小细胞肺癌患者代表了该疾病最具挑战性的管理问题。这一阶段疾病的患者可能有非常不同程度的淋巴结受累。病理证实这种参与是治疗决定的关键步骤。淋巴结损害程度的差异具有预后和治疗意义。基于多种考虑，患者可以接受诱导化疗、放化疗后手术或不手术的确定性放化疗。来自临床试验的数据为医生和患者提供了不完整的指导。最好的治疗方案是通过肺癌专业团队的多学科合作实现的。（JNCCN 2012;10：599-613）
Patients with stage IIIA non small cell lung cancer, determined based on involvement of ipsilateral mediastinal lymph nodes, represent the most challenging management problem in this disease. Patients with this stage disease may have very different degrees of lymph node involvement. The pathologic confirmation of this involvement is a key step in the therapeutic decision. The difference in the degree of lymph node compromise has prognostic and treatment implications. Based on multiple considerations, patients can be treated with induction chemotherapy, chemoradiotherapy followed by surgery, or definitive chemoradiotherapy without surgery. Data derived from clinical trials have provided incomplete guidance for physicians and their patients. The best therapeutic plan is achieved through the multidisciplinary cooperation of a team specialized in lung cancer. (JNCCN 2012;10:599-613)