El Sharouni S Y, Aerts J G J V, Senan S, De Ruysscher D K M, Groen H J M, Paul M A, Smit E F, Vonk E J A, Verhagen A F, Schramel F M N H
Universitaire Medisch Centrum Utrecht, afd. Radiotherapie, Q00.118, Heidelberglaan 100, 3584 CX Utrecht.
Ned Tijdschr Geneeskd. 2008 Dec 13;152(50):2714-7.
The treatment of patients with locally advanced non-small cell lung cancer (stage III) has changed significantly in the past few years. Patients with a non-resectable stage IIIA/B tumour are given combined treatment consisting ofchemotherapy and radiotherapy. These can be administered sequentially or concurrently. It has been shown recently that concurrent chemoradiotherapy gives a survival advantage in comparison with sequential chemoradiotherapy. Cisplatin and etoposide are usually the drugs of choice for chemotherapy in patients with stage III cancer. A biologically effective dose of radiotherapy equivalent to 60-66 Gy, over a maximum of 6.5 weeks, should be given. Surgery is possible for a selected group of patients, provided a complete objective mediastinal response has been achieved after chemoradiotherapy and a complete resection appears to be technically feasible. It is recommended to apply this treatment in a research setting. High-dose concurrent chemoradiotherapy is advised as the standard treatment for stage III non-small cell lung cancer in patients in good physical condition.
在过去几年中,局部晚期非小细胞肺癌(III期)患者的治疗发生了显著变化。不可切除的IIIA/B期肿瘤患者接受化疗和放疗联合治疗。这些治疗可以序贯或同步进行。最近研究表明,与序贯放化疗相比,同步放化疗具有生存优势。顺铂和依托泊苷通常是III期癌症患者化疗的首选药物。应给予生物等效剂量相当于60 - 66 Gy的放疗,疗程最长6.5周。对于部分经过选择的患者,如果在放化疗后实现了完全的纵隔客观缓解且完全切除在技术上可行,则可以进行手术。建议在研究环境中应用这种治疗方法。对于身体状况良好的III期非小细胞肺癌患者,建议采用高剂量同步放化疗作为标准治疗。