主页 > 医学文档 >
【文摘发布】手术辅助卡铂和VP16治疗可以切除的
INTRODUCTION:: The real benefit of surgical treatment of small cell lung cancer (SCLC) has never been demonstrated, mainly because of the rarity of surgical cases and the difficulty in comparing surgical and medical series for the different classifications systems used by surgeons (tumor, node, metastasis) and medical oncologists and radiotherapists (Veterans Administrations Lung Cancer Study Group). MATERIALS AND METHODS:: We prospectively assessed the utility of surgery after chemotherapy (carboplatin plus VP16 with or without ifosfamide) with or without radiotherapy in 23 patients with preoperative diagnosis of resectable stage I to IIIA SCLC. A median of three (range: three to six) courses of chemotherapy were administered. Five pneumonectomies, 12 lobectomies (seven sleeve resections), and two segmentectomies were performed, and all except one received radical lymph node dissection. Four (17%) patients received exploratory thoracotomy. Nine (39%) patients received postoperative thoracic radiotherapy. RESULTS:: Pathological stages were complete response in four patients, stage I in seven patients, stage II in seven patients, and stage III in five patients. Thirty-day morbidity and mortality were 9% and 0%, respectively. Surgery-related mortality at 90 days was 9%. Median follow-up was 19 months. Overall and local relapse rates were 52% and 17%, respectively. Median overall and disease-free survival were 24 and 12 months. Patients with complete response or pathological stage I had a significantly better Kaplan-Meier survival and lower incidence of relapse than those with more advanced pathological stage (p = 0.025 and 0.027, respectively, log rank). CONCLUSIONS:: Survival after chemotherapy and surgery in the series correlated with pathological but not pretreatment stage. Only patients with pathological stage 0 or I disease seem to benefit from surgical resection.
J Thorac Oncol. 2007 Feb;2(2):131-134.
链接： http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=17410028&itool=iconabstr&query_hl=2&itool=pubmed_docsum
[/color][color=red] 认领，24小时未翻译好则放弃 前言：手术在小细胞肺癌中的作用一直未被证实。这主要是由于手术的病例数较少，并且很难比较经手术的和未经手术的病例（由于外科医生 和内科及放疗科医生用于分期的手段不同）
材料和方法：23名术前评估可切除小细胞肺癌（I－IIIA）术前使用卡铂加VP16加或不加异环磷酰胺的化疗，加或不加术前放疗。平均化疗三个疗程（3－6），5例行全肺切除，12例肺叶切除（7例袖切），2例肺段切除术。除了一例其他都行了根治性淋巴切除。4例行了剖胸探查术。9例（39％）接受了术后放疗。
结果：术后分期4例达病理学完全缓解，7例I期，7例II期，5例III期，术后三十天的并发症和死亡率为9％和0，90天内手术相关死亡率9％，中位随访期19个月，总的和局部的复发率为52％和17％。中位总生存期和无病生存期分别为24个月和12个月，术后病理为完全缓解和I期的患者的生存率和复发率明显好于分期大于I期的患者（p分别为0.025和0.027）。
结论：小细胞肺癌的生存率与治疗前的分期无关，与术前化疗后的病理分期有关。只有病理学达到完全缓解及I期的患者能从手术中获益。 MATERIALS AND METHODS：We prospectively assessed the utility of surgery after chemotherapy (carboplatin plus VP16 with or without ifosfamide) with or without radiotherapy in 23 patients with preoperative diagnosis of resectable stage I to IIIA SCLC. A median of three (range: three to six) courses of chemotherapy were administered. Five pneumonectomies, 12 lobectomies (seven sleeve resections), and two segmentectomies were performed, and all except one received radical lymph node dissection. Four (17%) patients received exploratory thoracotomy. Nine (39%) patients received postoperative thoracic radiotherapy.
材 料和方法：23名术前评估可切除小细胞肺癌（I－IIIA）术前使用卡铂加VP16加或不加异环磷酰胺的化疗，加或不加术前放疗。平均化疗三个疗程（3－ 6），5例行全肺切除，12例肺叶切除（7例袖切），2例肺段切除术。除了一例其他都行了根治性淋巴切除。4例行了剖胸探查术。9例（39％）接受了术后 放疗。
更正为：
材 料和方法：我们前瞻性地研究了手术对２３名I 至IIIA期可被切除小细胞肺癌病人的治疗作用。这些病人手术前接受了化疗（卡铂加VP16加或不加异环磷酰胺），加或不加放疗。化疗３至６个疗程（中位３个）。５例全肺切除，１２例肺叶切除（７例袖式切除），２例肺段切除，除１例外所有病例接受了纵隔淋巴结根治术。４例病人（１７％）接受了探查术。９例病人（３９％）接受了术后放疗。 INTRODUCTION: The real benefit of surgical treatment of small cell lung cancer (SCLC) has never been demonstrated, mainly because of the rarity of surgical cases and the difficulty in comparing surgical and medical series for the different classifications systems used by surgeons (tumor, node, metastasis) and medical oncologists and radiotherapists (Veterans Administrations Lung Cancer Study Group).
阅读本文的人还阅读：
作者:admin@医学,生命科学 2010-11-30 05:11
医学,生命科学网