Kepka L, Casas F, Perin B, Abdel-Wahab S, Saghatelyan T, Vashkevitch L, Gaye P M, Dawotola D, Agarwal J P, Jeremic B
Department of Radiation Oncology, M. Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, ul. Roentgena 5, Warsaw, Poland.
Clin Oncol (R Coll Radiol). 2009 Sep;21(7):536-42. doi: 10.1016/j.clon.2009.04.001. Epub 2009 Apr 28.
Radiochemotherapy has become a standard approach in locally advanced non-small cell lung cancer and limited disease small cell lung cancer. Most of the data supporting this observation come from the developed world and only extremely rarely have good-quality clinical trials been carried out in developing countries. It is therefore of paramount importance to put the experience of the developed world into the context of the limited resources and other health care problems of developing countries. In this overview, the problems with the implementation of such data are discussed. The necessity of carrying out clinical trials specifically designed to address the needs of developing countries is emphasised. The research on cheaper ways of radiochemotherapy combination should be encouraged. The specific national guidelines for local needs should be created and followed. The availability of radiotherapy equipment is of major importance, as radiotherapy has a pivotal role in non-surgical treatment of lung cancer, especially in the developing world.
放化疗已成为局部晚期非小细胞肺癌和局限性小细胞肺癌的标准治疗方法。支持这一观点的大部分数据来自发达国家,而在发展中国家开展高质量临床试验的情况极为罕见。因此,将发达国家的经验置于发展中国家资源有限和其他医疗保健问题的背景下至关重要。在本综述中,讨论了此类数据实施过程中存在的问题。强调了开展专门针对发展中国家需求设计的临床试验的必要性。应鼓励研究更廉价的放化疗联合方法。应制定并遵循针对当地需求的具体国家指南。放疗设备的可及性至关重要,因为放疗在肺癌的非手术治疗中起着关键作用,尤其是在发展中国家。