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含 nab-紫杉醇诱导化疗联合手术切除治疗局部晚期非小细胞肺癌的疗效。

Therapeutic effect of induction therapy including nab-paclitaxel followed by surgical resection for the patients with locally advanced non-small-cell lung cancer.

机构信息

Department of Thoracic Surgery, Kanazawa Medical University, 1-1 Daigaku, Uchinada-Machi, Kahoku-Gun, Ishikawa, 920-0293, Japan.

出版信息

J Cardiothorac Surg. 2024 Jul 5;19(1):424. doi: 10.1186/s13019-024-02955-w.

Abstract

BACKGROUND

Lung cancer is associated with a high mortality rate worldwide. Non-small-cell lung cancer (NSCLC) is a major subtype of lung cancer. Carboplatin (CBDCA) plus nab-paclitaxel (PTX) has become a standard treatment for advanced unresectable NSCLC. However, treatment with nab-PTX has not been established as a standard therapy for resectable locally advanced (LA)-NSCLC.

METHODS

We conducted a comprehensive study involving consecutive patients with locally advanced NSCLC who underwent induction therapy including nab-PTX followed by surgical resection. Fifteen patients with locally advanced NSCLC underwent induction therapy including nab-PTX followed by surgical resection. Concurrent chemoradiotherapy (CRT) consisted of weekly administration of nab-PTX (50 mg/m) plus CBDCA (area under the plasma concentration time curve (AUC) 2) and thoracic radiotherapy (50 Gy/25 fractions).

RESULTS

The clinical stages were as follows: IIB (n =1), IIIA (n =12), and IIIC (n =2). Downstaging was observed in 73% (11/15) of patients on comparison with the clinical stage before concurrent CRT. Adverse drug reactions were observed in seven patients. Complete resection was performed in all patients. The re-evaluated pathological stage after pretreatment was diagnosed as stage 0 in three patients, stage IA1 in six, stage IA2 in one, and stage IIIA in five. The pathological effects of previous therapy were as follows: Ef3 (n =3), Ef2 (n =9), and Ef1a (n =3).

CONCLUSION

The therapeutic effect of induction therapy including nab-PTX was promising. Induction CRT, including nab-PTX, followed by resection, may be a viable alternative treatment option for locally advanced NSCLC.

摘要

背景

肺癌在全球范围内死亡率较高。非小细胞肺癌(NSCLC)是肺癌的主要亚型。卡铂(CBDCA)联合白蛋白紫杉醇(PTX)已成为晚期不可切除 NSCLC 的标准治疗方法。然而,nab-PTX 治疗尚未被确立为可切除局部晚期(LA)-NSCLC 的标准治疗方法。

方法

我们进行了一项综合研究,纳入了接受包括 nab-PTX 在内的诱导治疗后接受手术切除的局部晚期 NSCLC 连续患者。15 例局部晚期 NSCLC 患者接受了包括 nab-PTX 在内的诱导治疗,然后进行手术切除。同期放化疗(CRT)包括每周给予 nab-PTX(50mg/m)联合 CBDCA(AUC2)和胸部放疗(50Gy/25 个分次)。

结果

临床分期如下:IIB(n=1)、IIIA(n=12)和 IIIC(n=2)。与同期 CRT 前的临床分期相比,73%(11/15)的患者出现降期。7 例患者出现药物不良反应。所有患者均行完全切除。预处理后重新评估的病理分期,3 例诊断为 0 期,6 例诊断为 IA1 期,1 例诊断为 IA2 期,5 例诊断为 IIIA 期。既往治疗的病理效果如下:Ef3(n=3)、Ef2(n=9)和 Ef1a(n=3)。

结论

包括 nab-PTX 在内的诱导治疗的疗效令人鼓舞。包括 nab-PTX 的诱导 CRT 后进行切除可能是局部晚期 NSCLC 的一种可行的替代治疗选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/34bd/11225121/f298702e37b8/13019_2024_2955_Fig1_HTML.jpg

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