Division of Medical Oncology, Marmara University Medical School, Istanbul, Turkey.
Eur J Cancer. 2012 Sep;48(14):2163-5. doi: 10.1016/j.ejca.2012.04.006. Epub 2012 May 26.
Although pretreatment evaluations are well defined for the diagnosis of radically treatable NSCLC, we have very little data about the follow-up of these patients after completion of therapy, especially for stage III patients. No documented standards for surveillance were set in the NCCN, ACCP or ESMO guidelines. In order to determine the standard practice patterns of lung specialists, a survey was done. Physicians were asked which tests they do for pretreatment evaluation and also on asymptomatic patients during their post-treatment follow-up. The survey was sent to 192 centres which were part of the EORTC Lung Cancer Group. Thirty-eight centres from 12 different countries replied. Results showed that almost all the centres are doing very similar pretreatment evaluation procedures in stage III NSCLC. In the post-treatment follow-up setting, results were more varied in terms of frequency and type of scans used. The most commonly used test was a computed tomography (CT) of the chest and abdomen at 3 months post-treatment. Positron emission tomography (PET)/CT and magnetic resonance imaging (MRI) of the brain with contrast were done only in symptomatic patients. This audit suggests that one CT scan at 3 months after the end of radical treatment has become a standard with little evidence showing it is better than a chest radiography (CXR). These data should be used to encourage research into molecular parameters or new imaging techniques that could be tested as more sensitive methods of picking up relapse in radically treated stage IIIA patients who has a high relapse rate in the first 12 months.
尽管针对可根治性治疗的非小细胞肺癌(NSCLC)的诊断已经有明确的预处理评估标准,但我们对于这些患者在完成治疗后的随访情况却知之甚少,尤其是对于 III 期患者。NCCN、ACCP 和 ESMO 指南中并未设定明确的监测标准。为了确定肺部专家的标准实践模式,我们进行了一项调查。我们询问医生在进行预处理评估时以及在治疗后无症状患者的随访期间会进行哪些检查。该调查发送给了 EORTC 肺癌组的 192 个中心,共有 12 个不同国家的 38 个中心做出了回复。结果表明,在 III 期 NSCLC 中,几乎所有中心都采用非常相似的预处理评估程序。在治疗后随访中,使用的扫描频率和类型存在更多差异。最常用的检查是治疗结束后 3 个月时进行的胸部和腹部 CT 扫描。仅在有症状的患者中进行正电子发射断层扫描(PET)/CT 和增强磁共振成像(MRI)检查。这项审计表明,根治性治疗结束后 3 个月进行一次 CT 扫描已经成为标准做法,几乎没有证据表明这比胸部 X 线摄影(CXR)更好。这些数据应被用于鼓励对分子参数或新的成像技术进行研究,这些新技术可能被测试为更敏感的方法,以检测出在根治性治疗的 IIIA 期患者中复发率较高(在头 12 个月内)的复发情况。
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