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作 者:裴斯宁 于洪[2] PEI Sining;YU Hong(Dalian Medical University,Liaoing Dalian 116044,China;Department of Thoracic Radiotherapy,Liaoning Cancer Hospital and Institute,Liaoning Shenyang 110000,China)
机构地区:[1]大连医科大学,辽宁大连116044 [2]辽宁省肿瘤医院胸部放疗科,辽宁沈阳110000
出 处:《现代肿瘤医学》2023年第2期387-392,共6页Journal of Modern Oncology
摘 要:肺癌是世界公认的发病率和死亡率最高的一种恶性肿瘤,其中非小细胞肺癌(Non-small cell lung cancer,NSCLC)占80%~85%,并且初治时即被确诊为局部晚期(Ⅲ期)的患者高达30%以上。2010~2020年NCCN指南均推荐对于存在切除可能的患者,首选手术切除联合术后辅助化疗,5年生存率可提高5.4%,但临床应用多年生存率再无明显突破。新辅助治疗的应用为延长患者生存增添了可能,但2015年ESMO指南更倾向于选择术后辅助治疗,而不用新辅助治疗。NCCN指南则支持对合适的患者应进行新辅助治疗,方案多以含铂双药为主。同时随着目前靶向治疗和免疫治疗的进展,为新辅助治疗方案提供了更多的选择。本文就术前治疗方案的现状及研究进展作一综述。Lung cancer is a malignant tumor with the highest morbidity and mortality in the world.Non-small cell lung cancer(NSCLC) accounts for 80%~85%,and up to 30% of patients are diagnosed as locally advanced(stage Ⅲ) at the time of initial treatment.The 2010-2020 NCCN guidelines recommend that surgical resection combined with postoperative adjuvant chemotherapy is optimal for patients with possible resection.The 5-year survival rate can be increased by 5.4%,but there is no obvious breakthrough in survival rate after years of clinical application.The application of neoadjuvant therapy has increased the possibility of prolonging the survival of patients,but the 2015 ESMO guidelines are more inclined to choose postoperative adjuvant chemotherapy instead of preoperative neoadjuvant chemotherapy.NCCN guidelines support neoadjuvant chemotherapy for suitable patients.Most of them are mainly platinum-based doublet.With the progress of targeted therapy and immunotherapy,more options are provided for neoadjuvant therapy.This article reviews the current status and research progress of preoperative treatment options.
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