Negoro S
Department of Respiratory Medicine, Osaka City General Hospital, Japan.
Gan To Kagaku Ryoho. 1998 Sep;25(11):1671-9.
Unfortunately, most patients with non-small cell lung cancer (NSCLC) present with clinically unresectable advanced neoplasms. Since local treatment like surgery and radiation is not satisfactory for advanced NSCLC, effective systemic chemotherapy is necessary. But NSCLC is relatively resistant to chemotherapy. This report discusses the some recent issues in the treatment for advanced NSCLC. the issues are the following: 1) effect of post-operative chemotherapy and pre-operative induction chemotherapy in the patients with stage IIIA N2 disease; 2) efficacy combining chemotherapy with thoracic radiotherapy (TRT) in unresectable, locally advanced NSCLC; 3) timely combination of TRT and chemotherapy; 4) effect of chemotherapeutic agents as radiosensitizer; 5) potential effect of combination of TRT and new agents in unresectable, locally advanced NSCLC; 6) contribution of surgery following induction chemo-radiotherapy in locally advanced NSCLC; 7) reasons why response rate in cancer chemotherapy for advanced NSCLC does not always correlate with survival; 8) survival benefit of cancer chemotherapy in metastatic NSCLC; and 9) promising new agents (irinotecan, paclitaxel, docetaxel, vinorelbine and gemcitabine) along with combination chemotherapy, including these new agents.
不幸的是，大多数非小细胞肺癌（NSCLC）患者就诊时已出现临床上无法切除的晚期肿瘤。由于手术和放疗等局部治疗对晚期NSCLC并不令人满意，有效的全身化疗是必要的。但NSCLC对化疗相对耐药。本报告讨论了晚期NSCLC治疗中的一些近期问题。这些问题如下：1）IIIA期N2疾病患者术后化疗和术前诱导化疗的效果；2）不可切除的局部晚期NSCLC中化疗与胸部放疗（TRT）联合的疗效；3）TRT与化疗的适时联合；4）化疗药物作为放射增敏剂的效果；5）TRT与新药物联合在不可切除的局部晚期NSCLC中的潜在效果；6）诱导放化疗后手术对局部晚期NSCLC的作用；7）晚期NSCLC癌症化疗的缓解率为何并不总是与生存率相关的原因；8）转移性NSCLC中癌症化疗的生存获益；以及9）有前景的新药物（伊立替康、紫杉醇、多西他赛、长春瑞滨和吉西他滨）以及包括这些新药物在内的联合化疗。
