在局部晚期非小细胞肺癌的护理模式:来自印度的三级护理经验
Aswin Ravi1, Sushmita Pathy1, Supriya Mallick1
1Department of Radiation Oncology, All India Institute of Medical Sciences, New Delhi, India.
Lung India : official organ of Indian Chest Society
|October 23, 2025
概括
对于局部发达的非小细胞肺癌 (NSCLC),治愈性治疗提供了更长的生存期,特别是通过手术切除. 遵守治疗方案和良好表现状态是晚期肺癌患者的关键预后因素.
科学领域:
- 在瘤学瘤学.
- 胸部外科手术 胸部外科手术
- 医学瘤学 医学瘤学
- 辐射瘤学 辐射瘤学
背景情况:
- 局部发达的非小细胞肺癌 (LA-NSCLC) 呈现异质性,需要多学科的管理方法.
- 在可切除病例中,手术是标准的;否则,优先选择并发化疗辐射 (CCRT).
- 对LA-NSCLC治疗策略和结果的现实数据对于优化患者护理至关重要.
研究的目的:
- 对LA-NSCLC在现实环境中使用的多种治疗策略进行审计和分析.
- 评估与不同治疗方式相关的结果,包括无进展生存率 (PFS) 和总生存率 (OS).
- 确定影响LA-NSCLC患者生存的预后因素.
主要方法:
- 从2014年1月到2018年12月,对396名患有第三阶段NSCLC的患者的医疗记录进行了回顾性分析.
- 收集的数据包括人口统计,临床细节,治疗方法,结果和副作用.
- 使用卡普兰-梅尔曲线计算无进展生存率 (PFS) 和整体生存率 (OS),并使用Cox比例危险模型进行分析.
主要成果:
- 在接受治疗的310名患者中,有240人有治愈的意图. 手术切除 (前期或后期的新辅助化疗) 与绝对化疗放射治疗 (CTRT) 相比,显示出更好的生存结果.
- 200名患者接受了新辅助化疗 (NACT),但43.3%的患者后来被认为无法接受治愈局部治疗.
- 在多变量分析中,表现状况和对预期治疗的坚持是生存的显著预后因素.
结论:
- 对于符合条件的LA-NSCLC患者,应优先考虑治愈性治疗,特别是在可行的情况下进行外科切除,以实现更长的生存期.
- 始终坚持标准化治疗方案和强大的癌症护理设施对于改善结果至关重要.
- 虽然前置手术显示出更好的生存率,但与单独使用CCRT或SCRT相比,NACT跟随CCRT也显示出更好的结果.
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