Xu Peng, Le Pechoux Cecile
Department of Radiation Oncology, Sichuan Cancer Hospital, Chengdu, China.
Institut Gustave Roussy, 114 Rue Edouard Vaillant, 94800 Villejuif, France.
Chin Clin Oncol. 2015 Dec;4(4):45. doi: 10.3978/j.issn.2304-3865.2015.11.04.
Lung cancer is the leading cause of cancer-related mortality in men and the second leading cause in women. Approximately 85% of lung cancer patients have non-small cell lung cancer (NSCLC), and most present with advanced stage at diagnosis. The current treatment for such patients is chemoradiation (CRT) provided concurrently preferably or sequentially with chemotherapy, using conventionally fractionated radiation doses in the range of 60 to 66 Gy in 30 to 33 fractions. An individual patient data based metaanalysis has shown that in good performance status (PS), concomitant CRT was associated to improved survival by 4.5% compared to sequential combination (5-year survival rate of 15.1% and 10.6% respectively). In the recent years, improvement of modern technique of radiotherapy (RT) and new chemotherapy drugs may be favorable for the patients. Furthermore, the positron emission tomography-computed tomography (PET-CT) contributes to improved delineation of RT especially in terms of nodal involvement. Improving outcomes for patients with stage III disease remains a challenge, this review will address the questions that are considered fundamental to improving outcome in patients with stage III NSCLC.
肺癌是男性癌症相关死亡的主要原因，在女性中是第二大原因。大约85%的肺癌患者患有非小细胞肺癌（NSCLC），且大多数在诊断时已处于晚期。目前对此类患者的治疗是同步放化疗（CRT），最好与化疗同时或序贯进行，使用常规分割放射剂量，范围为60至66 Gy，分30至33次给予。一项基于个体患者数据的荟萃分析表明，在身体状况良好（PS）的患者中，同步CRT与序贯联合治疗相比，生存率提高了4.5%（5年生存率分别为15.1%和10.6%）。近年来，现代放射治疗（RT）技术的改进和新型化疗药物可能对患者有利。此外，正电子发射断层扫描 - 计算机断层扫描（PET-CT）有助于改善RT的靶区勾画，特别是在淋巴结受累方面。改善III期疾病患者的治疗效果仍然是一项挑战，本综述将探讨被认为是改善III期NSCLC患者治疗效果的基本问题。
