Van Houtte P, Roelandts M
Service de Radiothérapie, Institut Bordet, 121 boulevard de Waterloo, Brussels, Belgium.
Rev Mal Respir. 2008 Oct;25(8 Pt 2):3S167-72.
The most important progress made during the last years in the management of small cell lung cancer is certainly the recognition of the impact of chest radiotherapy for limited disease and prophylactic cranial irradiation (PCI) for patients in complete response. How to optimize chemotherapy and radiotherapy is the topic of this paper. The current trend is to deliver thoracic radiation concurrently with the first cycles of chemotherapy (cisplatine and etoposide). The total dose is still not defined and the subject of phase III trials. PCI is delivered at the end of the chemotherapy with moderate doses. The place of PCI in extensive disease is still debate even if there is a clear benefit in quality of life.
过去几年中,小细胞肺癌治疗取得的最重要进展无疑是认识到胸部放疗对局限性疾病的影响以及对完全缓解患者进行预防性脑照射(PCI)的作用。如何优化化疗和放疗是本文的主题。当前的趋势是在化疗(顺铂和依托泊苷)的首个周期同时进行胸部放疗。总剂量仍未确定,是III期试验的主题。PCI在化疗结束时以中等剂量进行。即使PCI对生活质量有明显益处,但在广泛期疾病中的地位仍存在争议。