Mott Timothy F
Department of Family Medicine Naval Hospital Pensacola, 6000 West Highway 98, Pensacola, FL 32512.
FP Essent. 2018 Jan;464:27-30.
Lung cancer management that is individualized for age, comorbidities, cancer type, cancer stage, and patient preference has long been a cornerstone of management. New to this realm of individualized management are the emerging biologic therapies, immunotherapies, and targeted therapies for non-small-cell lung cancer provided by advances in genetics and molecular medicine. These techniques have led to a new field of precision medicine based on the unique molecular characteristics of a specific patient and the specific cancer. However, standard management including surgery, chemotherapy, and radiation therapy remains the most common management options for stage I through III lung cancers. Advancements in precision medicine are most relevant to patients with stage IV (ie, metastatic) lung cancers. Functional patient assessment and pulmonary function testing are keys to preoperative assessment. Early palliative care and a minimally invasive approach to surgery should be considered in patients who can tolerate surgery.
根据年龄、合并症、癌症类型、癌症分期和患者偏好进行个体化的肺癌管理长期以来一直是治疗的基石。遗传学和分子医学的进展为非小细胞肺癌带来了新兴的生物疗法、免疫疗法和靶向疗法，这在个体化管理领域尚属新事物。这些技术基于特定患者和特定癌症的独特分子特征，催生了精准医学这一新领域。然而，包括手术、化疗和放疗在内的标准治疗仍然是I至III期肺癌最常见的治疗选择。精准医学的进展与IV期（即转移性）肺癌患者最为相关。对患者进行功能评估和肺功能测试是术前评估的关键。对于能够耐受手术的患者，应考虑早期姑息治疗和微创外科手术方法。
