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III期非小细胞肺癌的治疗选择:选择过多。

Stage III NSCLC treatment options: too many choices.

作者信息

Asmara Oke Dimas, Hardavella Georgia, Ramella Sara, Petersen René Horsleben, Tietzova Ilona, Boerma E Christiaan, Tenda Eric Daniel, Bouterfas Asmaa, Heuvelmans Marjolein A, van Geffen Wouter H

机构信息

Department of Respiratory Medicine, Medical Central Leeuwarden, Leeuwarden, The Netherlands.

Department of Sustainable Health, Faculty Campus Fryslân, University of Groningen, Leeuwarden, The Netherlands.

出版信息

Breathe (Sheff). 2024 Oct 1;20(3):240047. doi: 10.1183/20734735.0047-2024. eCollection 2024 Oct.

Abstract

Stage III nonsmall cell lung cancer (NSCLC) represents a wide range of tumour (T1 to T4) and nodal (N0 to N3) components, requiring variable management and a multidisciplinary approach. Recent advancements in minimally invasive techniques, molecular biology and novel drug discoveries have accelerated the refinement of stage III NSCLC management. The latest developments in staging include the forthcoming update of the nodal component in the 9th TNM (tumour-node-metastasis) edition, which emphasises the critical role for endobronchial ultrasonography in mediastinal staging. Recent treatment developments include the use of immunotherapy and targeted molecular therapy in both the neoadjuvant and adjuvant setting, either in combination with other modalities or used alone as consolidation. Surgical and radiotherapy advancements have further enhanced patient outcomes. These developments have significantly improved the prognosis for patients with stage III NSCLC. Fast-changing recommendations have also brought about a challenge, with clinicians facing a number of options to choose from. Therefore, a multimodal approach by a multidisciplinary team has become even more crucial in managing stage III NSCLC.

摘要

Ⅲ期非小细胞肺癌(NSCLC)包含多种肿瘤(T1至T4)和淋巴结(N0至N3)成分,需要采用不同的管理方式及多学科方法。微创技术、分子生物学和新型药物研发方面的最新进展加速了Ⅲ期NSCLC管理的优化。分期方面的最新进展包括即将在第9版TNM(肿瘤-淋巴结-转移)中更新淋巴结成分,这强调了支气管内超声在纵隔分期中的关键作用。近期的治疗进展包括在新辅助和辅助治疗中使用免疫疗法和靶向分子疗法,可与其他治疗方式联合使用或单独作为巩固治疗。手术和放疗方面的进展进一步改善了患者的治疗效果。这些进展显著改善了Ⅲ期NSCLC患者的预后。快速变化的推荐也带来了挑战,临床医生面临多种选择。因此,多学科团队采用的多模式方法在管理Ⅲ期NSCLC中变得更加关键。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e639/11444491/0e1dbea7784a/EDU-0047-2024.01.jpg

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