非小细胞肺癌新辅助治疗联合外科治疗的进展

肺癌是世界范围内发病率和死亡率最高的恶性肿瘤.对于可手术切除的Ⅲa/N2期非小细胞肺癌患者,目前国内外指南均推荐采用手术联合化疗、放疗等多学科治疗模式.最新研究表明,与术后辅助治疗一样,新辅助治疗(化疗或放化疗)可显著改善可切除非小细胞肺癌患者的预后,且在治疗依从性及耐受性方面具有明显优势.非小细胞肺癌新辅助治疗的对象主要是局部进展期病变,特别是临床Ⅲa/N2期患者,基本治疗模式为术前2-4周期化疗,新辅助治疗后并不增加手术相关的死亡及并发症风险,但是在决定手术时机、入路及切除范围等方面仍面临着挑战.

Progress of Neoadjuvant Therapy Combined with Surgery in Non-small Cell Lung Cancer

Background and objective Lung cancer is the leading form of cancer in terms of both incidence and cancer-related deaths. For patients with resectable Ⅲa/N2 non-small cell lung cancer (NSCLC), guidelines in and abroad recommend multidisciplinary team treatment, including surgery and chemotherapy, radiotherapy or other comprehensive treatment. Newly published evidences prove that neoadjuvant therapy can improve outcomes of NSCLC patients significantly, with advangtages in tolerability and compliance medication. Neoadjuvant therapy has been adopted mainly in locally advanced NSCLC, especially in stages Ⅲa/N2 patients, and chemotherapy of 2-4 cycles has become the basic pattern. Neoadjuvant therapy does not increase the concomitant complications of chemotherapy and surgery. However, challenges still exist in deter-mining subsequent surgical timing, approach and extent of resection.