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題名 | Induction Chemotherapy Before Surgical Resection Combined with Adjuvant Radiotherapy for Locally Advanced Non-Small Cell Lung Cancer (NSCLC)--Case Report and Review of Literature=於晚期局部性非小細胞肺癌患者,使用引導性化學治療,加上手術切除,合併使用輔助性放射性治療:病例報告以及文獻回顧 |
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作者姓名(中文) | 游介宇; 葉光揚; 林志銘; 鄺偉剛; 劉俊煌; 邱宗傑; 陳博明; | 書刊名 | 中華民國癌症醫學會雜誌 |
卷期 | 20:3 2004.09[民93.09] |
頁次 | 頁8-19 |
分類號 | 416.224 |
關鍵詞 | 非小細胞肺癌; 化學治療; 手術切除; 放射性治療; Neoadjuvant chemotherapy; Non-small cell lung cancer; Stage ⅢA N2 disease; Surgery; Radiotherapy; |
語文 | 英文(English) |
中文摘要 | 有好幾篇文獻結果顯示,在晚期局部性非小細胞肺癌患者,使用引導性化學治療加上手術切除,合併使用輔助性放射性治療,其治療的效果曾獲得肯定。於本文中,我們報告一例第三A期N2非小細胞肺癌患,使用Gemcitabine和Cisplatin作為引導性化學治療處方,並於三個療程引導性化學治療後接受左上肺葉切除以及縱隔腔淋巴結清除。後續使用54Gy劑量的放射線治療,術後追蹤二年仍無復發之證據。前導性化療的目的在於減少局部腫瘤體積,使開刀較容易;減少遠處轉移;以及評估腫瘤對化療的反應。如果前導性化療化寮後能夠導致分期下降,此時以外科手術切除將腫瘤及淋巴清除乾淨非常重要,為的是求得治癒腫瘤。術後輔助性電療可以減少局部復發,但對長期存活的影響則仍有爭議。對第三A期N2非小細胞肺癌患者而言,需要更多第二相及第三相的研究,進一步評估及決定最恰當的化學治療、放射線治療、以及手術治療的療程和方式。 |
英文摘要 | Induction chemotherapy before surgical resection of locally advanced non-small cell lung cancer (NSCLC) combined with adjuvant radiotherapy has been shown to improve survival compared with surgery alone in several clinical trials. A case report is presented describing the use of gemicitabine and cisplatin in a multimodality regimen for a patient with stage ⅢA N2 NSCLC. Three weeks after completing the neoadjuvant chemotherapy course, a left upper lobectomy with mediastinal lymphadenectomy was performed. The patient's postoperative course included adjuvant radiation therapy with 54 Gy to the mediastinum. He was doing well 2 years after surgery. Induction chemotherapy are aimed at decreasing the size of the locoregional tumor burden improving systemic, control of occult microscopic metastatic disease, and evaluation of response to chemotherapy. The role of the primary surgery has been proven to be of value with regard to an intent to cure after downstaging. Postoperative RT in patient with induction chemotherapy followed by surgery significantly improved local recurrence without evidence of improving overall survival. Studies should be undergone to determine the optimal type and timing of chemotherapy combined with surgery and radiotherapy for stage ⅢA N2 NSCLC. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。