摘要
Lung cancer is the leading cancer in terms of incidence and mortality in China and its incidence in China is predicted to increase in the next 20 years.1 The majority of the lung cancer patients are diagnosed with advanced stage disease,for which chemotherapy or targeted therapies are the mainstay palliative treatments.Before the identification of single-driver mutations,like the epidermal growth factor receptor (EGFR) mutation,platinum-based doublet was the standard first line treatment for advanced stage nonsmall cell lung cancer (NSCLC) patients with a good performance status (PS).However,patient prognosis remains poor and the modest treatment efficacy seems to have reached a plateau despite newer generation of platinum doublets.2 The recommendation for the duration of first line platinum doublet treatment is 4-6 cycles.3 The paradigm was based on the fact that a protracted course of chemotherapy did not prolong survival but introduced cumulative toxicities.4,5 The use of maintenance therapy (MT),defined by Grossi et al6 as the prolongation of chemotherapy with the administration of additional drugs at the end of a defined number of initial chemotherapy cycles after achieving maximum tumor response,was not considered as a standard option in the past.
Lung cancer is the leading cancer in terms of incidence and mortality in China and its incidence in China is predicted to increase in the next 20 years.1 The majority of the lung cancer patients are diagnosed with advanced stage disease,for which chemotherapy or targeted therapies are the mainstay palliative treatments.Before the identification of single-driver mutations,like the epidermal growth factor receptor (EGFR) mutation,platinum-based doublet was the standard first line treatment for advanced stage nonsmall cell lung cancer (NSCLC) patients with a good performance status (PS).However,patient prognosis remains poor and the modest treatment efficacy seems to have reached a plateau despite newer generation of platinum doublets.2 The recommendation for the duration of first line platinum doublet treatment is 4-6 cycles.3 The paradigm was based on the fact that a protracted course of chemotherapy did not prolong survival but introduced cumulative toxicities.4,5 The use of maintenance therapy (MT),defined by Grossi et al6 as the prolongation of chemotherapy with the administration of additional drugs at the end of a defined number of initial chemotherapy cycles after achieving maximum tumor response,was not considered as a standard option in the past.