临床N2期非小细胞肺癌治疗进展

临床N2期非小细胞肺癌(NSCLC)最佳治疗方案仍未确定,根治性同期化放疗为目前推荐的标准治疗方案.诱导化疗后同期化放疗并不优于标准的同期化放疗;术前新辅助化疗并未能提高总生存率,但新辅助同期化放疗后肺叶手术切除能提高总生存率.同期化放疗后继续巩固化疗作用仍有争论;吉非替尼或厄洛替尼维持治疗也未能带来生存受益.预防性脑照射仅能降低脑转移率,并未能提高总生存率.

Progress in treatment of clinical stage N2 non-small cell lung cancer

Although the optimal treatment protocol for clinical N2-stage non-small cell lung cancer (NSCLC) is still uncertain, the recommended standard treatment protocol goes to radical concurrent chemora diotherapy. Concurrent chemoradiotherapy after induction chemotherapy is not superior to standard concurrent chemoradiotherapy. Neoadjuvant concurrent chemoradiotherapy followed by pulmonary lobectomy can improve overall survival ratio comparaed with preoperative neoadjuvant concurrent chemoradiotherapy. The role of concurrent chemoradiotherapy followed by consooldation chemotherapy is still controversial. Gefitinib or erlotinib failed to bring about the survival benefit from the maintenance treatment after concurrent chemoradiotherapy. Prophylactic cranial irradiation play a role merely in decreasing the risk of brain metastases, but not in the improvement of overall survival.