recist1.1标准与eortc标准在egfrtkis治疗晚期 nsclc中疗效评价对比的研究-comparative study on efficacy evaluation between recist 1.1 standard and eortc standard in treatment of advanced ns clc with egrthkis.docxVIP

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recist1.1标准与eortc标准在egfrtkis治疗晚期 nsclc中疗效评价对比的研究-comparative study on efficacy evaluation between recist 1.1 standard and eortc standard in treatment of advanced ns clc with egrthkis.docx

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recist1.1标准与eortc标准在egfrtkis治疗晚期 nsclc中疗效评价对比的研究-comparative study on efficacy evaluation between recist 1.1 standard and eortc standard in treatment of advanced ns clc with egrthkis

目录中文摘要 ·············································································1 英文摘要 ·············································································5 英文缩写 ·············································································11 研究论文 RECIST 1.1 标准与 EORTC 标准在 EGFR-TKIs 治疗晚期 NS-CLC 中疗效评价对比的研究前言 ·············································································12 材料与方法 ····································································14 结果 ·············································································17 附图 ·············································································21 附表 ·············································································29 讨论 ·············································································33 结论 ·············································································38 参考文献 ·······································································39 综述晚期非小细胞肺癌的治疗及 PET/CT 在肺癌中的临床应用..........42 致谢 ···················································································53 个人简历 ·············································································54RECIST 1.1 标准与 EORTC 标准在 EGFR-TKIs 治疗晚期NSCLC 中疗效评价对比的研究摘要目的：肺癌是目前对人群健康和生命威胁最大的恶性肿瘤之一，且发病率和死亡率逐年上升，5 年生存率极低。非小细胞肺癌(Non Small Cell Lung Cancer, NSCLC)包括鳞状细胞癌、腺癌、大细胞癌等，约占所有肺癌的 80%，因其早期鲜有临床症状，约 75%的患者发现时已处于晚期，失去手术机会，化疗、局部放疗、以及分子靶向治疗等成为晚期非小细胞肺癌的主要治疗方式。以铂类为基础的化疗是目前国际上普遍采用的一线方案，随着科学技术的发展，培美曲塞及 EGFR-TKIs(Epithelial Growth Factor Receptor-tyrosine kinease inhibitors)等新药物问世后，已有大量临床试验证实其有效性及安全性，提高了患者的生活质量，延长了患者的生存时间。在患者接受治疗后，通常需要借助医学影像学来评价病灶变化情况，以明确治疗方案是否有效、是否需要更改治疗方案。目前临床上常用的是 2000 年颁布的实体瘤疗效评价标准(Response evaluation criteria in solid tumors，RECIST)1.0 版以及 2009 年修订的 RECIST 1.1 版。然而，RECIST1.1 标准没有将代表最先进医学影像的分子影像图像 PET/CT 的信息纳入标准内容，而临床中也通常仅仅在确定病灶的良恶性时参考 PET/CT。同时，一些新药如培美曲塞、EGFR-TKIs 等的应用，是否需要新的评价标准来评价病灶的变化成为很多人关心的问题。1999 年欧洲癌症研究和治疗组织(European Organzation for Research and Treatment