Analysis of further disease progression in metastatic non-small cell lung cancer: implications for locoregional treatment.
Analysis of further disease progression in metastatic non-small cell lung cancer: implications for locoregional treatment.
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DOI：
10.3892/ijo.25.6.1677
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发表时间：
2004-12
影响因子：
5.2
通讯作者：
N. Mehta;A. Mauer;S. Hellman;D. Haraf;E. Cohen;E. Vokes;R. Weichselbaum
中科院分区：
文献类型：
--
作者：
N. Mehta;A. Mauer;S. Hellman;D. Haraf;E. Cohen;E. Vokes;R. Weichselbaum
目的：确定在转移性非小细胞肺癌(NSCLC)的自然病程中，是否存在转移数目和/或目的器官有限的时间间隔。38例IIIB(胸腔积液)/IV期非小细胞肺癌患者接受了奥沙利铂和紫杉醇的II期试验。回顾了患者的病历，并记录了最初表现和后续随访时的所有疾病部位，包括所涉及的器官数量和单个转移部位的数量。临床表现时，74%的患者转移局限于一个或两个器官(包括原发肺)。50%的患者除肺原发灶外，还有3个转移灶。在最后一次随访中，17名患者出现了新的病变，14名患者出现了新的器官，3名患者出现了先前受累的器官。19例(50%)在最初受累部位有稳定(n=12)或进展(n=7)的疾病，没有发生任何新的转移肿瘤。在17例有4个转移灶和无胸腔积液的患者中，11例(65%)在最初的转移灶有稳定或进展的疾病，没有发展成新的转移灶。这些结果表明，转移性NSCLC患者中的一部分可能没有广泛传播的疾病，某种形式的局部治疗结合系统治疗对这些患者可能是有益的。我们的数据支持了临床试验的可行性，该试验结合了局部疗法来消毒非小细胞肺癌患者的转移瘤。
To determine whether in the natural history of metastatic non-small cell lung cancer (NSCLC) a time interval exists when metastases are limited in number and/or destination organs. Thirty-eight stage IIIB (pleural effusion)/IV NSCLC patients were treated on a phase II trial of oxaliplatin and paclitaxel. Patients' charts were reviewed and all sites of disease at initial presentation and at subsequent follow-ups were recorded, including the number of organs involved and the number of individual metastatic sites. At presentation, 74% of patients had metastases confined to one or two organs (including the lung primary). Fifty percent had < or =3 metastatic sites in addition to the lung primary. At last follow-up, 17 patients developed new lesions, 14 in a new organ and 3 in a previously involved organ. Nineteen (50%) had stable (n=12) or progressive (n=7) disease in initially involved sites without developing any new metastatic tumors. Among the 17 patients who presented with < or =4 metastatic sites and no pleural effusion, 11 (65%) had stable or progressive disease in initially involved sites without developing new metastases. These results suggest that a subset of patients who present with metastatic NSCLC may not have widely disseminated disease and that some form of local treatment combined with systemic therapy might be beneficial in these patients. Our data support the feasibility of a clinical trial that incorporates local therapies to sterilize metastases in patients with NSCLC.