Le Chevalier T
Department of Medicine, Institut Gustave-Roussy, Villejuif, France.
Semin Oncol. 1998 Aug;25(4 Suppl 9):62-5.
Surgery is the main curative treatment of patients with non-small cell lung cancer (NSCLC), but half of all patients will experience local or distant failure after complete resection. An individual data-based meta-analysis has suggested a 13% reduction in the risk of death and an absolute benefit of 5% at 5 years with adjuvant cisplatin-containing chemotherapy in patients with resected NSCLC. These data led several national and international groups to initiate a new generation of adjuvant trials in resected NSCLC, and more than 2,500 patients have already been included in these randomized studies. Chemotherapy can also be proposed preoperatively. Two randomized studies, which included 60 patients each, strongly suggested a benefit from neoadjuvant chemotherapy in patients with stage III NSCLC. A large French randomized study that included 375 patients with early stage NSCLC who did or did not receive preoperative chemotherapy has recently been completed. This study should help clarify the role of neoadjuvant chemotherapy in operable NSCLC.
手术是非小细胞肺癌（NSCLC）患者的主要治疗方法，但所有患者中有一半在完全切除后会出现局部或远处复发。一项基于个体数据的荟萃分析表明，接受含顺铂辅助化疗的NSCLC切除患者死亡风险降低13%，5年时的绝对获益为5%。这些数据促使多个国家和国际组织开展了新一代NSCLC切除术后辅助试验，已有2500多名患者纳入这些随机研究。化疗也可在术前进行。两项随机研究（各纳入60例患者）有力地表明，新辅助化疗对Ⅲ期NSCLC患者有益。一项大型法国随机研究最近完成，该研究纳入了375例早期NSCLC患者，部分患者接受了术前化疗，部分未接受。这项研究应有助于阐明新辅助化疗在可手术NSCLC中的作用。
