Molina Julian R, Adjei Alex A, Jett James R
Division of Medical Oncology, Mayo Clinic College of Medicine, Rochester, MN 55905, USA.
Chest. 2006 Oct;130(4):1211-9. doi: 10.1378/chest.130.4.1211.
In the United States, lung cancer kills more men and woman than the next three most common cancers combined. Unfortunately, the long-term outcome of lung cancer is still dismal with a 5-year survival rate of 15%. However, significant improvements in median survival times and 1-year and 2-year survival rates have been achieved in the last decade. This progress has been accomplished not only because of better surgical techniques but also because of the use of platinum-based regimens with newer chemotherapy agents and, more recently, targeted therapy. The role of chemotherapy as an integral part of the treatment of lung cancer has expanded significantly, particularly in the last few years with the proven benefit of adjuvant chemotherapy. For advanced stage non-small cell lung cancer (NSCLC), chemotherapy prolongs survival and improves quality of life in patients with good performance status, and appears to provide symptomatic improvement in patients with decreased performance status. Platinum-based doublet chemotherapy regimens are now the standard of care in patients with advanced stage NSCLC, and non-platinum-based combination therapies are reasonable alternatives in certain populations. The combination of the vascular endothelial growth factor inhibitor bevacizumab and chemotherapy has proven to prolong survival. As agents such as monoclonal antibodies, small molecules inhibitors of tyrosine kinase, and direct inhibitors of proteins involved in lung cancer proliferation are being developed and tested, we are optimistic that these agents will result in improvement in the survival and quality of life of lung cancer patients.
在美国，肺癌导致的男性和女性死亡人数超过接下来三种最常见癌症的死亡人数总和。不幸的是，肺癌的长期预后仍然不容乐观，5年生存率仅为15%。然而，在过去十年中，中位生存时间以及1年和2年生存率都有了显著提高。这一进展的取得不仅得益于更好的手术技术，还得益于含铂方案与更新的化疗药物的使用，以及最近靶向治疗的应用。化疗作为肺癌治疗不可或缺的一部分，其作用已显著扩大，特别是在过去几年中，辅助化疗已被证明具有益处。对于晚期非小细胞肺癌（NSCLC），化疗可延长生存时间并改善身体状况良好患者的生活质量，对于身体状况较差的患者似乎也能缓解症状。含铂双药化疗方案目前是晚期NSCLC患者的标准治疗方案，非铂类联合疗法在某些人群中是合理的替代方案。血管内皮生长因子抑制剂贝伐单抗与化疗联合使用已被证明可延长生存期。随着单克隆抗体、酪氨酸激酶小分子抑制剂以及肺癌增殖相关蛋白直接抑制剂等药物的研发和试验，我们乐观地认为这些药物将改善肺癌患者的生存和生活质量。
