Surgical adjuvant therapy of non‐ small‐ cell lung cancer
Surgical adjuvant therapy of non‐ small‐ cell lung cancer
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非小细胞肺癌的手术辅助治疗
DOI：
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发表时间：
1991
期刊：
影响因子：
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通讯作者：
E. Holmes
中科院分区：
文献类型：
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作者：
E. Holmes
肺癌研究小组的几项研究结果表明，术后辅助化疗可以提高肺癌手术后的生存率。在一项研究中，术后使用环磷酰胺、阿霉素、顺铂（CAP）化疗的18个月无病生存率几乎翻了一番。然而，复发率仍然显著。晚期可切除疾病的患者似乎从术后化疗中获益最多。结果还表明，CAP在非鳞状肺癌患者中比在鳞状肺癌患者中更有效地延缓复发。术前辅助治疗的使用也引起了相当大的兴趣。术前或诱导治疗的研究发现，无论是单独化疗还是联合放疗，都显示出很高的反应率，并且无法切除的疾病患者可以转化为技术上可切除的疾病。尽管术前治疗可能导致手术解剖困难，但手术并发症是可以接受的。术前化疗放疗后手术切除可明显消除局部复发。系统性复发仍然是一个重大问题。到目前为止，还没有证据表明术前辅助治疗可以延长生存期。
Results of several studies by the Lung Cancer Study Group have shown that postoperative adjuvant chemotherapy enhances survival following surgery for lung cancer. The 18‐ month disease‐ free survival almost doubled in one study using cyclophosphamide, doxorubicin, cisplatin (CAP) chemotherapy postoperatively. The recurrence rate remained significant, however. Patients with more advanced resectable disease seem to benefit most from postoperative chemotherapy. Results also suggest that CAP delays recurrences more effectively in patients with nonsquamous vs. squamous lung carcinoma. There has been considerable interest in the use of preoperative adjuvant therapy as well. Findings from studies of preoperative or induction therapy—either chemotherapy alone or in combination with radiation therapy—have shown high response rates and that patients with unresectable disease can be converted to technically resectable. Although preoperative therapy can cause difficulties with surgical dissection, surgical morbidity is acceptable. Preoperative chemotherapy and radiotherapy followed by surgical resection clearly eliminates local recurrence. Systemic recurrences remain a significant problem. The evidence, as yet, does not indicate that preoperative adjuvant therapy prolongs survival.