高风险患者的治疗 I 阶段非小细胞肺癌患者的治疗
Arjun Pennathur1, Michael Lanuti2, Robert E Merritt3
1Department of Cardiothoracic Surgery, University of Pittsburgh School of Medicine, University of Pittsburgh Medical Center, and UPMC Hillman Cancer Center, Pittsburgh, Pennsylvania.
Seminars in thoracic and cardiovascular surgery
|December 13, 2024
概括
对于高风险的第一阶段非小细胞肺癌 (NSCLC),治疗决策涉及复杂的因素. 如果是安全的,则优先进行手术,并采用立体性除性放射疗法 (SABR) 或图像导导热除 (IGTA) 作为替代方案.
科学领域:
- 胸部外科手术 胸部外科手术
- 辐射瘤学 辐射瘤学
- 医学瘤学 医学瘤学
背景情况:
- 许多第一阶段非小细胞肺癌 (NSCLC) 患者面临着带切除术的高风险.
- 美国胸腔外科协会 (AATS) 之前的指导方针确定了高风险患者的标准.
研究的目的:
- 评估高风险I期NSCLC患者的治疗选择.
- 确定影响该群体治疗选择的关键因素.
主要方法:
- 由AATS临床实践标准委员会召集的专家小组审查了文献.
- 经过修改的Delphi方法被用于开发共识陈述和临床细节.
- 声明批准需要达到75%的共识值.
主要成果:
- 亚叶切除,图像导向热除 (IGTA) 和立体性除性放射疗法 (SABR) 被确定为适用的治疗方法.
- 通过了14份共识陈述和5份临床报告.
- 对于非手术候选人来说,SABR被认为是下一个最佳选择.
结论:
- 对高风险I期NSCLC的治疗选择是复杂的,在安全的情况下有利于手术.
- 对于某些患者来说,SABR和IGTA是可行的替代方案.
- 治疗前的活检和多学科审查对于最佳的决策至关重要,考虑到患者的偏好和生活质量.
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