Tarasevych Svitlana, Lauwers Patrick, Vandaele Frederik, van Meerbeeck Jan P
Department of Thoracic Oncology, Multidisciplinary Oncology Center Antwerp University Hospital, Antwerp, Belgium.
Expert Rev Anticancer Ther. 2014 Sep;14(9):1007-20. doi: 10.1586/14737140.2014.929500. Epub 2014 Jun 14.
In the last 5 years, the current management of stage I non-small-cell lung cancer has been challenged due to novel surgical approaches and advances in radiation technology. The outcome after a sublobar resection is promising, especially for tumors less than 2 cm. Other treatment opportunities are available for high risk patients with comorbidity and impaired pulmonary function. Stereotactic ablative body radiotherapy is a good alternative treatment to surgery, especially in elderly and comorbid patients. However, randomized evidence comparing sublobar resection and stereotactic radiotherapy is presently lacking. The most recent development in radiotherapy is hadron therapy with a presumed reduced toxicity because of its peculiar physical and biological effects. Promising thermal and microwave ablative techniques are in development and have specific niche indications.
在过去5年中，由于新型手术方法和放射技术的进步，I期非小细胞肺癌的当前管理面临挑战。亚肺叶切除术后的结果很有前景，尤其是对于小于2厘米的肿瘤。对于合并症和肺功能受损的高危患者，还有其他治疗选择。立体定向消融体部放疗是手术的一种良好替代治疗方法，尤其是在老年和合并症患者中。然而，目前缺乏比较亚肺叶切除和立体定向放疗的随机证据。放射治疗的最新进展是强子治疗，由于其特殊的物理和生物学效应，推测其毒性降低。有前景的热消融和微波消融技术正在研发中，并有特定的适用范围。
