Department of Oncology and Palliative Medicine, Nordland Hospital , Bodø , Norway ; Institute of Clinical Medicine, Faculty of Health Sciences, University of Tromsø , Tromsø , Norway.
Front Oncol. 2013 Jul 9;3:176. doi: 10.3389/fonc.2013.00176. eCollection 2013.
The important role of combined chemoradiation for several groups of patients with non-small cell lung cancer (NSCLC) is reflected by the large number of scientific articles published during the last 30 years. Different measures of impact and clinical relevance of published research are available, each with its own pros and cons. For this review, article citation rate was chosen. Highly cited articles were identified through systematic search of the citation database Scopus. Among the 100 most often cited articles, meta-analyses (n = 5) achieved a median of 203 citations, guidelines (n = 7) 97, phase III trials (n = 29) 168, phase II trials (n = 21) 135, phase I trials (n = 7) 88, and others combined 115.5 (p = 0.001). Numerous national and international cooperative groups and several single institutions were actively involved in performing often cited, high-impact trials, reflecting the fact that NSCLC is a world-wide challenge that requires research collaboration. Platinum-containing combinations have evolved into a standard of care, typically administered concurrently. The issue of radiotherapy fractionation and total dose has also been studied extensively, yet with less conclusive results. Differences in target volume definition have been addressed. However, it was not possible to test all theoretically possible combinations of radiotherapy regimens, drugs, and drug doses (lower radiosensitizing doses compared to higher systemically active doses). That is why current guidelines offer physicians a choice of different, presumably equivalent treatment alternatives. This review identifies open questions and strategies for further research.
在过去的 30 年里，大量的科学文献发表，反映了联合放化疗对几组非小细胞肺癌 (NSCLC) 患者的重要作用。现已有多种用于评估已发表研究的影响力和临床相关性的指标，各有优缺点。在本次综述中，我们选择了文章引用率作为评估指标。通过系统地在 Scopus 引文数据库中搜索，确定了高引用率的文章。在 100 篇最常被引用的文章中，荟萃分析（n=5）的中位数引用次数为 203 次，指南（n=7）为 97 次，III 期临床试验（n=29）为 168 次，II 期临床试验（n=21）为 135 次，I 期临床试验（n=7）为 88 次，其他类型综合引用率为 115.5（p=0.001）。众多国家和国际合作组以及一些单机构积极参与了常被引用、高影响力的试验，这反映了 NSCLC 是一个全球性的挑战，需要开展研究合作。含铂联合方案已发展为一种标准治疗方法，通常与放疗同时进行。放疗分割和总剂量问题也得到了广泛研究，但结果并不确定。靶区定义的差异已得到解决。然而，目前还不可能测试放疗方案、药物和药物剂量（与全身有效剂量相比，较低的放射增敏剂量）的所有理论上可能的组合。这就是为什么目前的指南为医生提供了不同的、可能等效的治疗选择。本综述确定了仍存在的问题和进一步研究的策略。
