Department of Surgery, Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.
Department of Research, Netherlands Comprehensive Cancer Organisation, Utrecht, The Netherlands.
Acta Oncol. 2020 Jul;59(7):748-752. doi: 10.1080/0284186X.2020.1757150. Epub 2020 Apr 29.
Concurrent chemoradiotherapy remains the main treatment strategy for patients with stage IIIA non-small cell lung cancer (NSCLC); stage cT3N1 or cT4N0-1 may be eligible for surgery and potentially resectable stage IIIA (N2) NSCLC for neoadjuvant therapy followed by resection. We evaluated treatment patterns and outcomes of patients with stage IIIA NSCLC in The Netherlands. Primary treatment data of patients with clinically staged IIIA NSCLC between 2010 and 2016 were extracted from The Netherlands Cancer Registry. Patient characteristics were tabulated and 5-year overall survival (OS) was calculated and reported. In total, 9,591 patients were diagnosed with stage IIIA NSCLC. Of these patients, 41.3% were treated with chemoradiotherapy, 11.6% by upfront surgery and 428 patients (4.5%) received neoadjuvant treatment followed by resection. The 5-year OS was 26% after chemoradiotherapy, 40% after upfront surgery and 54% after neoadjuvant treatment followed by resection. Clinical over staging was seen in 42.3% of the patients that were operated without neoadjuvant therapy. In The Netherlands, between 2010 and 2016, 4.5% of patients with stage IIIA NSCLC were selected for treatment with neoadjuvant therapy followed by resection. The 5-year OS in these patients exceeded 50%. However, the outcome might be overestimated due to clinical over staging.
同期放化疗仍然是 IIIA 期非小细胞肺癌（NSCLC）患者的主要治疗策略；cT3N1 或 cT4N0-1 期患者可能有手术适应证，并可能对新辅助治疗后可切除的 IIIA（N2）期 NSCLC 进行手术。我们评估了荷兰 IIIA 期 NSCLC 患者的治疗模式和结局。从荷兰癌症登记处提取了 2010 年至 2016 年临床分期为 IIIA NSCLC 的患者的主要治疗数据。对患者特征进行了列表分析，并计算和报告了 5 年总生存率（OS）。共有 9591 例患者被诊断为 IIIA 期 NSCLC。其中，41.3%的患者接受了放化疗，11.6%的患者接受了根治性手术，428 例（4.5%）患者接受了新辅助治疗后再手术。放化疗后 5 年 OS 为 26%，根治性手术后 5 年 OS 为 40%，新辅助治疗后再手术的 5 年 OS 为 54%。未行新辅助治疗而手术的患者中，临床过分期占 42.3%。在荷兰，2010 年至 2016 年期间，4.5%的 IIIA 期 NSCLC 患者选择接受新辅助治疗后再手术。这些患者的 5 年 OS 超过 50%。然而，由于临床过分期，可能高估了结果。
