Adjuvant chemotherapy for surgically resected non-small cell lung cancer
Adjuvant chemotherapy for surgically resected non-small cell lung cancer
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DOI：
10.1016/j.jtcvs.2012.03.039
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发表时间：
2012-09-01
影响因子：
6
通讯作者：
Johnson, Bruce E.
中科院分区：
文献类型：
--
作者：
Heon, Stephanie;Johnson, Bruce E.
尽管手术切除，早期(I至IIIA)非小细胞肺癌(NSCLC)患者仍有相当大的复发和死亡风险。近年来，已有多项大型随机试验评估辅助化疗对切除的非小细胞肺癌的疗效。在对300名或更多的早期非小细胞肺癌患者进行的6项试验中，有3项已经证明，在精心挑选的切除非小细胞肺癌患者中，以顺铂为基础的辅助化疗可以显著提高5年存活率。这些益处已在现代顺铂佐剂试验的荟萃分析中得到证实。据报道，在切除II期和IIIA期NSCLC的患者中，益处最一致。对于切除的IB期非小细胞肺癌患者，辅助化疗的益处还不是很具体。在这里，我们回顾了主要辅助化疗试验的结果及其对完全切除的非小细胞肺癌患者的治疗意义。未来的挑战将是确定将从辅助化疗中获得最大好处的患者亚群。目前也在进行试验，以确定新的靶向治疗，如表皮生长因子受体抑制剂和单抗，在辅助治疗策略中的作用。(《胸心外科杂志》2012；144：S39-42)
Despite surgical resection, patients with early-stage (I to IIIA) non-small cell lung cancer (NSCLC) are at considerable risk of recurrence and death from their lung cancer. In recent years, multiple, large, randomized trials assessing the efficacy of adjuvant chemotherapy for resected NSCLC have been reported. Three of 6 trials with 300 or more patients with early-stage NSCLC have demonstrated that adjuvant cisplatin-based chemotherapy can significantly improve 5-year survival in carefully selected patients with resected NSCLC. These benefits have been confirmed in a meta-analysis of modern cisplatin-based adjuvant trials. The most consistent benefit has been reported in patients with resected stage II and IIIA NSCLC. The benefit of adjuvant chemotherapy in patients with resected stage IB NSCLC is less concrete. Herein, we review the results of the major adjuvant chemotherapy trials and their implications for the treatment of patients with completely resected NSCLC. A future challenge will be to identify the subsets of patients who will derive the greatest benefit from adjuvant chemotherapy. Current trials are also under-way to define the role of novel targeted therapies, such as inhibitors of the epidermal growth factor receptor and monoclonal antibodies, in adjuvant treatment strategies. (J Thorac Cardiovasc Surg 2012; 144:S39-42)