Sculier J P
Rev Med Brux. 2014 May-Jun;35(3):134-9.
The present updated guidelines on the management of resectable non-small cell lung cancer (NSCLC) formulated by the ELCWP are designed to answer the following questions: 1) Is conventional surgery the best treatment for potentially resectable cancer? 2) What is the definition of a complete resection? 3) Should we make a systematic lymphadenectomy in case of surgery for a N0 or N1 tumor? 4) What is the role of radiation therapy after complete resection? 5) In case of clinical stage I or II, should administer adjuvant or neoadjuvant chemotherapy? 6) In case of pathological stage I or II, should administer adjuvant chemotherapy? 7) In case of complete resection for stage IIIA N2 disease, should be offered adjuvant therapy and if so which one: chemotherapy, radiotherapy, chemoradiotherapy? 8) In case of clinical stage IIIA or B, what are the indications for surgery after induction therapy? 9) In case of clinical stage IIIA or B, if surgical indication is retained, should we do an induction treatment, and if so, which one? 10) In case of incomplete resection after primary surgery, what should be the postoperative therapy? 11) In case of (neo)adjuvant chemotherapy, which association should be offered and what dosage of cisplatin to be prescribed? 12) Can stereotactic radiotherapy replace surgery in operable patients? 13) What is proposed for the patient unfit for conventional surgery treatment? 14) Have targeted therapies a place in the treatment ?
欧洲肺癌工作组(ELCWP)制定的这份最新的可切除非小细胞肺癌(NSCLC)管理指南旨在回答以下问题:1)传统手术是否是潜在可切除癌症的最佳治疗方法?2)完全切除的定义是什么?3)对于N0或N1期肿瘤进行手术时,是否应进行系统性淋巴结清扫?4)完全切除后放疗的作用是什么?5)对于临床I期或II期患者,是否应给予辅助或新辅助化疗?6)对于病理I期或II期患者,是否应给予辅助化疗?7)对于IIIA期N2疾病完全切除的患者,是否应给予辅助治疗,如果是,应选择哪种:化疗、放疗、放化疗?8)对于临床IIIA期或B期患者,诱导治疗后手术的指征是什么?9)对于临床IIIA期或B期患者,如果保留手术指征,是否应进行诱导治疗,如果是,应选择哪种?10)初次手术后不完全切除的患者,术后治疗应该是什么?11)对于(新)辅助化疗,应选择哪种联合方案以及顺铂的处方剂量是多少?12)立体定向放疗能否替代可手术患者的手术?13)对于不适合传统手术治疗的患者有何建议?14)靶向治疗在治疗中是否有一席之地?