Dept of Radiation Oncology, University Hospitals Leuven/KU Leuven, Leuven, Belgium Both authors contributed equally
Thoracic Surgery Division, National Cancer Center Hospital, Tokyo, Japan Both authors contributed equally.
Eur Respir J. 2014 Aug;44(2):483-94. doi: 10.1183/09031936.00020214. Epub 2014 Jun 12.
Lobectomy and systematic nodal dissection are still the standard for small-size (<3 cm) nonsmall cell lung cancer. There is growing interest in more parenchyma-sparing surgery, so-called sublobar resections (wedge resection or segmentectomy). Indeed, nonrandomised trials suggest that a segmentectomy may result in local control rates that are similar to lobectomy. Nonsurgical approaches, such as stereotactic ablative radiotherapy, consistently result in local control rates of ∼ 90% and survival rates that are comparable to lobectomy. Therefore, we are moving towards an era in which several therapeutic possibilities are available, that are probably equivalent from an oncological point of view. Further trials are needed to define the optimal therapy for individual patients.
肺叶切除术和系统淋巴结清扫术仍然是小尺寸（<3 厘米）非小细胞肺癌的标准治疗方法。人们对更能保留肺实质的手术（所谓的亚肺叶切除术，楔形切除术或肺段切除术）越来越感兴趣。实际上，非随机试验表明，肺段切除术可能会达到与肺叶切除术相似的局部控制率。非手术方法，如立体定向消融放疗，始终能达到约 90%的局部控制率和与肺叶切除术相当的生存率。因此，我们正朝着一个有多种治疗可能性的时代发展，从肿瘤学的角度来看，这些治疗方法可能是等效的。需要进一步的试验来为个体患者确定最佳治疗方法。
