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Current therapeutic strategies in inoperable non small-cell lung cancer

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Author:: No author available

Journal Title:: CHINESE JOURNAL OF TUBERCULOSIS AND RESPIRATORY DISEASES

Issue:: 2

DOI:: 10.3760/j:issn:1001-0939.2002.02.029

Key Word:: No keyword available

Abstract： @@ 非小细胞肺癌(non-small cell lung cancer,NSCLC)占原发性肺癌的75%～80%.就诊时已有70%～80%属中、晚期,失去手术机会.这部分患者总的5年生存率低于5%[1] .约1/3的NSCLC属于Ⅲ期,即所谓局部晚期.过去,高剂量放疗是局部或局部晚期N SCLC的常规疗法.单纯胸部放疗的中位生存期<1年,5年生存率仅5%～7%.尽管新的放疗方法不断推出,如超分割放疗、加速超分割放疗,以及连续超分割加速放疗等.胸部放疗能控制局部病灶,并有效缓解肿瘤引起的症状,但对于提高晚期肿瘤患者的生存率作用不大 .其容易转移的特性与低生存率有关,因而需予以有效的全身性治疗.以顺铂为基础的联合化疗对于提高Ⅲ～Ⅳ期患者的生存率具有肯定的疗效.对于Ⅲ期患者,全身化疗+局部放疗的综合治疗方式已经取得了良好的结果.一些随机试验和Meta分析已经证实,对于有良好的生活质量评分及体重下降轻微的患者,同步或序贯放、化疗能提高疗效和生存期,但5年生存率仍有待进一步提高[1,2].影响疗效的因素主要有:(1)局部病灶的控制;(2)远处转移灶或微转移灶的控制;(3)癌细胞的耐药性;(4)化、放疗本身引起的毒副作用.肺癌的非手术综合治疗包括化疗、放疗、免疫治疗、基因治疗等,我国还有独具特色的中药治疗.序贯或同步化放疗的应用提高了局部晚期肺癌患者的缓解率和生存率,是近年来的重要进展.我们就国内外对不能手术的NSCLC的综合治疗,主要为序贯化放疗、同步放化疗、中药治疗以及克服肺癌耐药性的策略的最新进展作一综合报道与评述.

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