Brahmer Julie R, Ettinger David S
Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD 21231-1000, USA.
Respirology. 2007 May;12(3):320-5. doi: 10.1111/j.1440-1843.2007.01081.x.
Of all cancers, non-small cell lung cancer is one of the most commonly diagnosed and is the deadliest. With a dismissal survival rate even in the early stages of disease, investigations of adjuvant and neo-adjuvant therapy have not had much impact until the 21st century. Starting in 2004, several randomized trials have shown significant improvements in survival treating patients with stage II and III disease. Adjuvant chemotherapy remains controversial in patients with stage I disease, in which most trials have not demonstrated a survival advantage. Investigators are studying molecular and genetic factors, which may predict who might benefit most from adjuvant therapy. While adjuvant therapy is now standard, neo-adjuvant therapy either with chemotherapy alone or with concurrent chemotherapy and radiation has shown promise, but has yet to become a clear standard of care. Data are presented to support the standard use of adjuvant therapy in patients with stage II and III disease, as well as data supporting the use of neo-adjuvant therapy in selected patients with non-small cell lung cancer.
在所有癌症中，非小细胞肺癌是最常被诊断出的癌症之一，也是最致命的癌症之一。即使在疾病早期，其预后生存率也很低，直到21世纪，辅助治疗和新辅助治疗的研究都没有太大影响。从2004年开始，多项随机试验表明，对II期和III期疾病患者进行治疗可显著提高生存率。辅助化疗在I期疾病患者中仍存在争议，大多数试验并未证明其具有生存优势。研究人员正在研究分子和遗传因素，这些因素可能预测谁最能从辅助治疗中获益。虽然辅助治疗现在已成为标准治疗方法，但单独使用化疗或联合化疗及放疗的新辅助治疗已显示出前景，但尚未成为明确的标准治疗方案。本文提供的数据支持在II期和III期疾病患者中使用辅助治疗的标准做法，以及支持在选定的非小细胞肺癌患者中使用新辅助治疗的数据。
