非小细胞肺癌术后辅助治疗的临床应用调查

Survey on the Application of Adjuvant Therapy in Completely Resected Non-Small Cell Lung Cancer Patients

目的了解我国临床医师对非小细胞肺癌完全切除术后辅助治疗的应用情况并与循证指南进行比较。方法调查对象为2009年5月16日参加全国性非小细胞肺癌辅助治疗研讨会的130名临床医师。调查内容包括临床医师的一般资料和术后辅助治疗情况。结果共回收有效问卷120份(92.31%)。顺铂是最常用的铂类(80.67%)。联合化疗药物依次为吉西他滨(50.42%)、长春瑞滨(37.82%)、多西紫杉醇(33.61%)和紫杉醇(19.33%)。化疗周期数多数为4个(86.44%)。ⅢA(N2)期术后辅助放疗、ⅠB期患者和高龄患者(>75岁)术后辅助化疗分别为77.59%、68.07%和%33.61%。33.33%的医师选择予腺癌患者术后辅助靶向治疗。结论我国临床医师对于非小细胞肺癌术后辅助化疗的应用基本与现有指南一致。但对ⅠB期和ⅢA(N2)期有过度治疗倾向。

Objectives We conducted a survey to assess and compare Chinese physicians＇ practice of adjuvant therapy in completely resected non-small cell lung cancer （NSCLC） patients against the evidence-based guidelines. Methods On May 16,2009,130 Chinese physicians who attended a national NSCLC symposium were surveyed. The survey questionnaire included physician＇s demographics and adjuvant therapy questions. Results 120 valid questionnaires were returned （92.31%）. Cisplatin is the platinum of choice （80.67%）. The most commonly combined drugs are Gemcitabine（50.42%）, Vinorelbin（37.82%）, Docetaxel （33.61%）and Paclitaxel （19.33% ）. 4 cycles is the mostly selected. The choosing of adjuvant radiotherapy in stage Ⅲ A（N2）, adjuvant chemotherapy in Stage Ⅰ B and elderly patients（〉75 years old） are 77.59%,68.07% and 33.61% respectively. 33.33% of physicians selected adjuvant targeted therapy for adenocarcinoma. Conclusions The practice of adjuvant chemotherapy in NSCLC is in agreement with current evidence-based guideline; howevers, there is tendency of overtreatment in stage Ⅰ B and ⅢA（N2） patients.