Pujol J L, Daurès J P, Godard P, Michel F B
Hôpital Arnaud de Villeneuve, Département d'Information Médicale. Centre Hospitalier Régional et Universitaire, Montpellier.
Rev Pneumol Clin. 1994;50(4):147-54.
Locally advanced non-small cell lung cancers have a poor prognosis following surgery alone when this has been possible, because of a high rate of local and metastatic relapses. Probability of five years survival for these patients ranges between 5 and 15%. Thus, locally advanced non small cell lung cancer for which resection is potentially possible but poorly curative are usually designated as marginally resectable. Adjuvant postoperative chemotherapy or radiation therapy hardly seem to improve survival. Therefore, other combined modality treatments might be proposed. Neoadjuvant chemotherapy may be used for non small cell lung cancer in an attempt (a) to improve complete resection rate and (b) to treat non-detectable metastatic disease. Numerous phase II studies have demonstrated the faisability of this combined modality in locally advanced non small cell lung cancers, particularly in stage N2 patients. Until the results of the ongoing phase III studies would be known, neoadjuvant chemotherapy might be considered as an investigational approach.
局部晚期非小细胞肺癌在可行手术的情况下，若仅行手术治疗，预后较差，因为局部复发和远处转移的发生率很高。这些患者的五年生存率在5%至15%之间。因此，对于那些有可能切除但治愈性较差的局部晚期非小细胞肺癌，通常被定义为边缘可切除。术后辅助化疗或放疗似乎很难提高生存率。因此，可能需要采用其他综合治疗方法。新辅助化疗可用于非小细胞肺癌，目的是：（a）提高完全切除率；（b）治疗隐匿性转移疾病。大量II期研究已证明这种综合治疗方法在局部晚期非小细胞肺癌，尤其是N2期患者中的可行性。在正在进行的III期研究结果出来之前，新辅助化疗可被视为一种试验性方法。
