非小细胞肺癌:流行病学、危险因素、治疗及生存情况。

Non-small cell lung cancer: epidemiology, risk factors, treatment, and survivorship.

作者信息

Molina Julian R, Yang Ping, Cassivi Stephen D, Schild Steven E, Adjei Alex A

机构信息

Department of Oncology, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA.

出版信息

Mayo Clin Proc. 2008 May;83(5):584-94. doi: 10.4065/83.5.584.

Abstract

Lung cancer is the leading cause of cancer-related mortality not only in the United States but also around the world. In North America, lung cancer has become more predominant among former than current smokers. Yet in some countries, such as China, which has experienced a dramatic increase in the cigarette smoking rate during the past 2 decades, a peak in lung cancer incidence is still expected. Approximately two-thirds of adult Chinese men are smokers, representing one-third of all smokers worldwide. Non-small cell lung cancer accounts for 85% of all lung cancer cases in the United States. After the initial diagnosis, accurate staging of non-small cell lung cancer using computed tomography or positron emission tomography is crucial for determining appropriate therapy. When feasible, surgical resection remains the single most consistent and successful option for cure. However, close to 70% of patients with lung cancer present with locally advanced or metastatic disease at the time of diagnosis. Chemotherapy is beneficial for patients with metastatic disease, and the administration of concurrent chemotherapy and radiation is indicated for stage III lung cancer. The introduction of angiogenesis, epidermal growth factor receptor inhibitors, and other new anti-cancer agents is changing the present and future of this disease and will certainly increase the number of lung cancer survivors. We identified studies for this review by searching the MEDLINE and PubMed databases for English-language articles published from January 1, 1980, through January 31, 2008. Key terms used for this search included non-small cell lung cancer, adenocarcinoma, squamous cell carcinoma, bronchioalveolar cell carcinoma, large cell carcinoma, lung cancer epidemiology, genetics, survivorship, surgery, radiation therapy, chemotherapy, targeted therapy, bevacizumab, erlotinib, and epidermal growth factor receptor.

摘要

肺癌不仅是美国也是全球癌症相关死亡的主要原因。在北美,肺癌在既往吸烟者中比当前吸烟者中更为常见。然而在一些国家,比如中国,在过去20年吸烟率急剧上升,预计肺癌发病率仍将出现峰值。约三分之二的中国成年男性吸烟,占全球所有吸烟者的三分之一。非小细胞肺癌占美国所有肺癌病例的85%。在初步诊断后,使用计算机断层扫描或正电子发射断层扫描对非小细胞肺癌进行准确分期对于确定合适的治疗方法至关重要。在可行的情况下,手术切除仍然是唯一最一致且成功的治愈选择。然而,接近70%的肺癌患者在诊断时已出现局部晚期或转移性疾病。化疗对转移性疾病患者有益,同步放化疗适用于III期肺癌。血管生成抑制剂、表皮生长因子受体抑制剂及其他新型抗癌药物的引入正在改变这种疾病的现状和未来,肯定会增加肺癌幸存者的数量。我们通过检索MEDLINE和PubMed数据库,查找1980年1月1日至2008年1月31日发表的英文文章来确定本综述的研究。本次检索使用的关键词包括非小细胞肺癌、腺癌、鳞状细胞癌、细支气管肺泡细胞癌、大细胞癌、肺癌流行病学、遗传学、生存、手术、放射治疗、化疗、靶向治疗、贝伐单抗、厄洛替尼和表皮生长因子受体。

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