Sørensen J B, Hansen H H
Department of Oncology ONB, Finsen Institute, Copenhagen, Denmark.
Cancer Surv. 1989;8(3):671-9.
Adenocarcinoma of the lung (ACL) attracts increasing attention because of the fast rising incidence. Systemic chemotherapy with cytostatic agents has been widely used for patients with inoperable ACL, but a standard treatment has not yet been defined. A review of the literature revealed that the highest response rates observed for single agents and combination chemotherapy in ACL in randomized studies were 22% and 38%, respectively, while the longest median survivals were 35 weeks and 34 weeks. Independent prognostic factors for survival in ACL patients were performance status, prior non-radical resection, liver metastases, white blood cell count and serum values of lactate dehydrogenase and aspartic aminotransaminase. Using logistic regression analysis, the only significant predictor of response was measurable disease parameter, while 26 other variables were not significant. Response to chemotherapy was not a major prognostic factor for survival, probably because of the low rate of complete responses (4%). Chemotherapy in ACL remains experimental and the prognosis for these patients is poor. High priority should therefore be given to the identification of new agents or combination regimens with appreciable activity. The knowledge of prognostic factors should be used for optimal design of trials and interpretation of the results.
由于肺癌腺癌（ACL）发病率迅速上升，其受到越来越多的关注。细胞毒性药物的全身化疗已广泛应用于无法手术的ACL患者，但尚未确定标准治疗方案。文献综述显示，在随机研究中，ACL单药治疗和联合化疗观察到的最高缓解率分别为22%和38%，而最长中位生存期分别为35周和34周。ACL患者生存的独立预后因素包括体能状态、既往非根治性切除、肝转移、白细胞计数以及乳酸脱氢酶和天冬氨酸转氨酶的血清值。使用逻辑回归分析，唯一显著的缓解预测因素是可测量的疾病参数，而其他26个变量并不显著。化疗反应不是生存的主要预后因素，可能是因为完全缓解率较低（4%）。ACL的化疗仍处于试验阶段，这些患者的预后较差。因此，应高度重视确定具有明显活性的新药物或联合方案。预后因素的知识应用于试验的优化设计和结果的解释。
