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肺癌:当前的诊断与治疗。

Lung cancer: current diagnosis and treatment.

机构信息

Abteilung Pneumologie, Department für Innere Medizin, Neurologie und Dermatologie, Universitätsklinik Leipzig, Leipzig, Germany.

出版信息

Dtsch Arztebl Int. 2009 Dec;106(49):809-18; quiz 819-20. doi: 10.3238/arztebl.2009.0809. Epub 2009 Dec 4.

Abstract

BACKGROUND

Much progress has been made in the treatment of lung cancer in the last ten years (adjuvant chemotherapy, targeted therapy, individualized therapy). Nonetheless, lung cancer is still the leading cause of death due to cancer and thus remains a major medical, scientific, and social problem.

METHOD

This review is based on national and international recommendations and selected articles from the literature.

RESULTS

Cigarette smoking is the major pathogenic factor for lung cancer. Lung cancer can be divided into two major types that differ in their biological behavior, small cell lung cancer and non-small cell lung cancer. Whenever possible, the diagnosis should be confirmed by biopsy, the extent of disease should be documented in detail (international TNM classification/staging), and the patient's functional level should be assessed with a view toward treatment planning. Surgery for non-small cell lung cancer with curative intent is possible up to stage IIIA, while stage IIIB is the domain of radiotherapy. Surgery for small cell lung cancer with curative intent is possible for rare cases in early stages (T1N0 and T2N0, i.e., stage IA and IB). As long as small cell lung cancer is restricted to one side of the chest, simultaneous radiation therapy and chemotherapy are indicated. If a malignant pleural effusion or distant metastases are present, both lung cancers are treated palliatively with platinum-based chemotherapy.

摘要

背景

在过去的十年中,肺癌的治疗取得了很大进展(辅助化疗、靶向治疗、个体化治疗)。尽管如此,肺癌仍是癌症死亡的主要原因,因此仍是一个主要的医学、科学和社会问题。

方法

本综述基于国家和国际建议以及文献中的精选文章。

结果

吸烟是肺癌的主要致病因素。肺癌可分为两种主要类型,其生物学行为不同,即小细胞肺癌和非小细胞肺癌。只要可能,诊断应通过活检确认,疾病的范围应详细记录(国际 TNM 分类/分期),并评估患者的功能水平,以便进行治疗规划。非小细胞肺癌的根治性手术可达到 IIIA 期,而 IIIB 期则为放疗的适应证。小细胞肺癌根治性手术在早期(T1N0 和 T2N0,即 IA 和 IB 期)罕见病例中可行。只要小细胞肺癌局限于一侧胸部,就应同时进行放疗和化疗。如果存在恶性胸腔积液或远处转移,两种肺癌均采用含铂化疗进行姑息性治疗。

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本文引用的文献

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Maintenance therapy in non-small-cell lung cancer.
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