临床Ⅰ期高龄非小细胞肺癌的治疗进展

Advances of Treatment about Elderly Clinical Stage I Non-small Cell Lung Cancer

随着人口的老龄化,高龄肺癌患者的比例在增大。近十几年来肺叶切除加纵隔淋巴结清扫一直是I期非小细胞肺癌(non small cell lung cancer,,NSCLC)患者的标准术式。近年研究发现Ⅰ期高龄NSCLC亚肺叶切除术可以取得和肺叶切除术相当的远期疗效而且可以保留更多的正常肺组织,有关Ⅰ期NSCLC的标准术式再次引起争议。Ⅰ期高龄NSCLC患者是一个特殊的群体,常因机体功能减退或合并有基础疾病而无法耐受开胸手术,胸腔镜的问世以及立体定向放射治疗技术的发展使患者有了更多的选择。

With the aging of the population,the proportion of elderly lung cancer is increasing.More than ten years,lobectomy with mediastinal lymph node dissection has been the standard surgery for stage 1 non-small cell lung cancer （NSCLC）.However,recent studies found that sublobectomy could get the same long-term outcome with the lobectomy for elderly clinical stage I NSCLC and more normal lung tissue could be retained.It becomes controversial again about the standard surgery of stage I NSCLC at present.Elderly stage I NSCLC is a special group,who often can not tolerate thoracotomy because of the poor body function and some comorbidities,but the thoracoscopic surgery and the stereotactic radiotherapy technology （STRT） supply them more options.The treatment of eldly stage I NSCLC is developing towards to the individualization and diversification.