Department of Thoracic Surgery, European Institute of Oncology IRCCS, 20141 Milan, Italy.
Department of Oncology and Hemato-Oncology, University of Milan, 20141 Milan, Italy.
Curr Oncol. 2023 Mar 7;30(3):3160-3175. doi: 10.3390/curroncol30030239.
Lung cancer is the second-most commonly diagnosed cancer and the leading cause of cancer death worldwide. The most common histological type is non-small-cell lung cancer, accounting for 85% of all lung cancer cases. About one out of three new cases of non-small-cell lung cancer are diagnosed at a locally advanced stage-mainly stage III-consisting of a widely heterogeneous group of patients presenting significant differences in terms of tumor volume, local diffusion, and lymph nodal involvement. Stage III NSCLC therapy is based on the pivotal role of multimodal treatment, including surgery, radiotherapy, and a wide-ranging option of systemic treatments. Radical surgery is indicated in the case of hilar lymphnodal involvement or single station mediastinal ipsilateral involvement, possibly after neoadjuvant chemotherapy; the best appropriate treatment for multistation mediastinal lymph node involvement still represents a matter of debate. Although the main scope of treatments in this setting is potentially curative, the overall survival rates are still poor, ranging from 36% to 26% and 13% in stages IIIA, IIIB, and IIIC, respectively. The aim of this article is to provide an up-to-date, comprehensive overview of the state-of-the-art treatments for stage III non-small-cell lung cancer.
肺癌是全球第二大常见癌症,也是癌症死亡的主要原因。最常见的组织学类型是非小细胞肺癌,占所有肺癌病例的 85%。大约三分之一的新诊断非小细胞肺癌为局部晚期-主要是 III 期-包括广泛异质性的一组患者,在肿瘤体积、局部扩散和淋巴结受累方面存在显著差异。III 期 NSCLC 的治疗基于多模式治疗的关键作用,包括手术、放疗和广泛的全身治疗选择。如果存在肺门淋巴结受累或同侧纵隔单站受累,可能在新辅助化疗后,可考虑根治性手术;对于多站纵隔淋巴结受累的最佳治疗方法仍存在争议。尽管该治疗方案的主要范围是潜在治愈性的,但总生存率仍然较差,分别为 IIIA、IIIB 和 IIIC 期的 36%、26%和 13%。本文旨在提供 III 期非小细胞肺癌最新、全面的治疗方法概述。