Service des Soins Intensifs and Oncologie Thoracique, Institut Jules Bordet, Centre des Tumeurs de l'Université Libre de Bruxelles, 1 rue Héger-Bordet, B-1000 Bruxelles, Belgium.
Eur Respir J. 2012 Jan;39(1):9-28. doi: 10.1183/09031936.00190310. Epub 2011 Jul 7.
The present systematic review was performed under the auspices of the European Lung Cancer Working Party (ELCWP) in order to determine the role of early intermediate criteria (surrogate markers), instead of survival, in determining treatment efficacy in patients with lung cancer. Initially, the level of evidence for the use of overall survival to evaluate treatment efficacy was reviewed. Nine questions were then formulated by the ELCWP. After reviewing the literature with experts on these questions, it can be concluded that overall survival is still the best criterion for predicting treatment efficacy in lung cancer. Some intermediate criteria can be early predictors, if not surrogates, for survival, despite limitations in their potential application: these include time to progression, progression-free survival, objective response, local control after radiotherapy, downstaging in locally advanced nonsmall cell lung cancer (NSCLC), complete resection and pathological TNM in resected NSCLC, and a few circulating markers. Other criteria assessed in these recommendations are not currently adequate surrogates of survival in lung cancer.
本系统评价是在欧洲肺癌工作组（ELCWP）的主持下进行的，目的是确定早期中间标准（替代标志物）在确定肺癌患者治疗效果方面的作用，而不是生存。最初，对使用总生存来评估治疗效果的证据水平进行了审查。然后，ELCWP 提出了 9 个问题。在对这些问题的文献进行专家审查后，可以得出结论，总生存仍然是预测肺癌治疗效果的最佳标准。一些中间标准可以是生存的早期预测指标，如果不是替代指标，尽管它们在潜在应用方面存在局限性：这些包括无进展生存期、进展时间、客观缓解、局部晚期非小细胞肺癌（NSCLC）放疗后的局部控制、降期、完全切除和术后病理 TNM 分期，以及一些循环标志物。这些建议中评估的其他标准目前不是肺癌生存的充分替代指标。
