NCCN非小细胞肺癌指南解读演示幻灯片.pptVIP

* * * * * * * * * * * * * * In order to give a clear conclusion on the treatment of completely resected patients, a meta-analysis on all the CDDP-based chemotherapies used in adjuvant was conducted, and the results presented this year at ASCO. * * * * The LACE meta-analysis confirms the significant impact of adjuvant chemotherapy on survival. NB: The Big Lung Trial (BLT) is a study from Great Britain examining the role of cisplatin-based chemotherapy in a variety of treatment settings in patients with NSCLC. Among these, patients with completely resected stage I-III NSCLC were randomly assigned to three cycles of pre- (4%) or postoperative (96%) cisplatin-based chemotherapy or surgery alone. Note that this trial was not designed to specifically answer a surgical adjuvant question and is thus underpowered to detect a clinically significant survival difference.Its individual data were considered inside LACE meta-analysis. * * * * The absolute survival benefit at 5 years is greater than 5%. * * * * * 研究根据临床分期和研究中心分层，随机分单纯手术组141例和新辅助化疗组129例，后者在化疗后3-6周内都接受手术，之后两组都进行随访。 研究结论认为：新辅助化疗耐受性良好；新辅助化疗缓解率为35%与以往S9900和LU22研究的报道接近。 但结果由于早期截至所以有所限制，总体上，新辅助化疗组较单纯手术组3年PFS增加5%(3年OS增加7%)，新辅助化疗的显著性优势只在IIB-IIIA期亚组得到体现。因此，提示我们新辅助化疗是否应该也在选择的早期非小细胞肺癌病人中进行呢？这点值得我们思考。 * * * * * * * * * * * The INT 0139 randomized trial is the first large-scale study of patients with pathologically confirmed mediastinal nodes, a subgroup of patients who have a poor prognosis following surgery or radiotherapy alone. It addresses the controversial issue of whether surgical resection can improve survival. The researchers compared concurrent chemotherapy and radiotherapy with chemotherapy and radiation therapy combined with surgical resection for stage IIIA N2 non-small-cell lung cancer. Medically fit patients who met strictly defined criteria for adequate pulmonary function were eligible if resection was technically feasible. Induction therapy for all randomized patients was two cycles of cisplatin and etopo