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[肺癌放化疗的最新进展]

[The recent progress in chemoradiotherapy of lung cancer].

作者信息

Ogawara M, Kawahara M, Furuse K

机构信息

Department of Internal Medicine, National Kinki-Central Hospital for Chest Diseases, Sakai, Japan.

出版信息

Gan To Kagaku Ryoho. 1997 Nov;24(14):2058-64.

PMID:9388514
Abstract

This is a review of the recent progress in chemoradiotherapy of locally advanced lung cancer. In the limited disease stage of small cell lung cancer, a meta-analysis showed patients treated with a combination of chemotherapy and radiotherapy have a statistically significantly longer survival than those with chemotherapy alone. However, the timing of the combination of radiation and chemotherapy has not been clarified. One study favored late over early use of radiotherapy for survival. Another randomized study and a meta-analysis revealed earlier radiotherapy had a better prognosis. JCOG performed a randomized phase III study comparing concurrent chemoradiotherapy with chemotherapy followed by radiotherapy, and the final results will be published in the near future. In the past, radiotherapy alone had been considered standard therapy for inoperable locally advanced non-small cell lung cancer. Several randomized studies and meta-analyses demonstrated the combination of chemotherapy and radiotherapy produced better survival rates than by radiotherapy alone. Our randomized study indicated the addition of radiotherapy after chemotherapy is superior in long-term survival to chemotherapy alone. The West Japan Lung Cancer Group conduct a phase III randomized study comparing concurrent and sequential chemoradiotherapy, and the determination of survival is now in the follow-up stage. The role of induction chemoradiotherapy before surgical resection, comparison of chemoradiotherapy with induction chemoradiotherapy followed by surgery, and the effects and safety of the combination of new drugs and radiotherapy are now under investigation.

摘要

这是一篇关于局部晚期肺癌放化疗近期进展的综述。在小细胞肺癌的局限期,一项荟萃分析显示,接受化疗联合放疗的患者生存期在统计学上显著长于单纯接受化疗的患者。然而,放疗与化疗联合的时机尚未明确。一项研究支持晚期而非早期使用放疗以延长生存期。另一项随机研究和一项荟萃分析表明,早期放疗预后更佳。日本临床肿瘤学会(JCOG)开展了一项随机III期研究,比较同步放化疗与序贯化疗后放疗,最终结果将于近期公布。过去,单纯放疗一直被视为不可切除的局部晚期非小细胞肺癌的标准治疗方法。多项随机研究和荟萃分析表明,化疗与放疗联合的生存率高于单纯放疗。我们的随机研究表明,化疗后加用放疗在长期生存方面优于单纯化疗。日本西部肺癌研究组开展了一项III期随机研究,比较同步和序贯放化疗,目前生存情况的判定正处于随访阶段。术前诱导放化疗的作用、放化疗与诱导放化疗后手术的比较,以及新药与放疗联合的效果和安全性目前正在研究中。

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