2022年医学专题—同步放化疗肺癌中文版(1).ppt

Management of unresectable stage non-small cell lung cancer:the role of combined chemoradiation,第一页，共二十九页。,introduction,Until the late 1980s,thoracic radiation therapy(TRT)remained the standard care for locally advanced NSCLC.,第二页，共二十九页。,Radiation alone?,Sequential chemoradiation?,第三页，共二十九页。,CALGB8433,Dillman RO,NEJM 323:940-945,1990,Dillman RO,JNCI 88:1210-1215,1996,第四页，共二十九页。,RTOG8808,Sause W,JNCI1995;87:198-205,Sause W,CHEST2000;117:358-364,第五页，共二十九页。,OS,第六页，共二十九页。,60y survival,第七页，共二十九页。,FRANCE,Thierry Le Chevaliar,JNCI1991;83:417-423,CT:VCPC,vindesine,cyclophosphamide,cisplatin,lomustine,第八页，共二十九页。,Concurrent chemoradiation?,Radiation alone?,第九页，共二十九页。,EORTC,Schaake-Koning C,NEJM 1992;326:524-530,第十页，共二十九页。,Intensified regimen,Jeremic B,JCO 1995;13:452-458,Lee JS,JCO 1994;14:1055-1064,CT:weekly,100mg/m2 CBP D1,D2;100mg/m2 VP-16 D1-3,CT:200mg/m2 CBP D1,D2;100mg/m2 VP-16 D1-5,the first,third,and fifth weeks,第十一页，共二十九页。,Meta Analysis,Results(52 trials,9387 pts),2-year survival 4%。Hazard ratio:0.87。,NSCLC CG,BMJ 1995;311:899-909,第十二页，共二十九页。,Concurrent chemoradiation?,Sequential chemoradiation?,第十三页，共二十九页。,Furuse K,JCO 1999;17:2692-2699,Japan,第十四页，共二十九页。,RTOG9410,Curran WJ,PASCO 2000;19:484a,第十五页，共二十九页。,ACR427(phase),Choy H,PASCO 2002;abstract:1160,第十六页，共二十九页。,GLOT9501,Pierre F,PASCO 2001;abstract:1246,第十七页，共二十九页。,第十八页，共二十九页。,CALGB9431,Methods:2 cycles induction followed by 2 cycles and concurrent TRT,66Gy,Vokes EE,JCO 2002;20:4191-4198,第十九页，共二十九页。,CALGB9431,第二十页，共二十九页。,SWOG9019,Patients:50 pts.IIIB Treatment:PE 2cycles/RT PE 2cycles,Albain KS,JCO 2002;20:3454-3460,第二十一页，共二十九页。,SWOG9019,MST:15months,1y-sur:58%,2y-sur:33%,3y-sur:17%,5y-sur:15%,第二十二页，共二十九页。,SWOG9504,Patients:83pts.IIIB Treatment:PE 2cycles/RT Docetaxel 3 cycles(75mg/m2 for the first and 100mg/m2 for the last two cycles).,Gandara DR,JCO 2003;21:2004-2010,第二十三页，共二十九页。,SWOG9504,1y-sur:76%,MST:26months,2y-sur:54%,3y-sur:37%,第二十四页，共二十九页。,SWOG9019/9504,Gandara DR,JCO 2003;21:2004-2010,第二十五页，共二十九页。,Hossier Oncology Group,Induction cisplatin/etoposide TRT,Docetaxel,Observation,第二十六页，共二十九页。,CALGB9801,Induction PC,No Induction PC,concurrent carboplatin/paclitaxel TRT,第二十七页，共二十九页。,SWOG0023,PE/TRT,Consolidation docetaxel,Oral Gefitinib,placebo,第二十八页，共二十九页。,内容(nirng)总结,Management of unresectable stage non-small cell lung cancer:the role of combined chemoradiation。2 year survival。2-year survival。Sause W,CHEST2000。Thierry Le Chevaliar,JNCI1991。CT:200mg/m2 CBP D1,D2。P/P,第二十九页，共二十九页。,