术前顺铂联合 S-1 化疗和放疗可诱导局部晚期（III 期）非小细胞肺癌患者降期。

Preoperative chemoradiotherapy using cisplatin plus S-1 can induce downstaging in patients with locally advanced (stage III) non-small-cell lung cancer.

机构信息

Department of Surgery, Hamanomachi General Hospital, 3-5-27 Maizuru, Chuo-ku, Fukuoka 810-8359, Japan.

出版信息

Anticancer Res. 2012 Nov;32(11):5099-104.

DOI:

PMID:23155287

Abstract

BACKGROUND

About 30% of patients with non-small cell lung cancer (NSCLC) have locally advanced cancer (stage IIIA or IIIB) at the time of presentation. Many institutions have reported treatment with preoperative chemoradiotherapy (PCRT) followed by curative resection in patients with stage III NSCLC, but the optimal therapeutic protocol for this group has not been established.

PATIENTS AND METHODS

Nineteen patients with stage III NSCLC were treated with PCRT, followed by surgery at the Hamanomachi Hospital, Fukuoka, Japan from May 2000 to November 2011. We evaluated the effectiveness of PCRT for inducing downstaging using mainly three chemoradiotherapy regimens; cisplatin plus Tegafur-Gimeracil-Oteracil Potassium (S-1), cisplatin plus Tegafur-Uracil (UFT), or 1,1'cyclobutanedicarboxylate (Carboplatin, CBDCA) plus paclitaxel, with concurrent radiation therapy in 19 patients with stage III NSCLC.

RESULTS

The overall 5-year survival rate was 57.1%, which is higher than the average survival rate for patients with stage III NSCLC in Japan. Among the regimens used, only cisplatin plus S-1 with concurrent radiation therapy significantly induced downstaging. There was a significant difference in survival time between the downstaged and non-downstaged groups. However, there was no significant difference in survival time between the S-1 plus cisplatin group and the other groups combined, because of the short observation period for the S-1 plus cisplatin group.

CONCLUSION

PCRT using cisplatin plus S-1 with concurrent radiation therapy is useful for inducing downstaging in patients with locally advanced stage III NSCLC.

摘要

背景

约 30%的非小细胞肺癌（NSCLC）患者在就诊时患有局部晚期癌症（III 期 A 或 IIIB 期）。许多机构报告了对 III 期 NSCLC 患者进行术前放化疗（PCRT）加根治性切除术的治疗，但该组患者的最佳治疗方案尚未确定。

患者和方法

19 例 III 期 NSCLC 患者于 2000 年 5 月至 2011 年 11 月在日本福冈市滨町医院接受了 PCRT 治疗，随后进行了手术。我们主要使用三种放化疗方案（顺铂加替加氟-吉美嘧啶-奥替拉西钾（S-1）、顺铂加替加氟-尿嘧啶（UFT）或 1,1'环丁烷二羧酸酯（卡铂，CBDCA）加紫杉醇）评估了 PCRT 诱导降期的效果，对 19 例 III 期 NSCLC 患者进行同期放疗。