早期非小细胞肺癌综合治疗的进展

Progress in the Comprehensive Treatment of Early Non-Small Cell Lung Cancer

新辅助治疗和手术切除是目前治疗非小细胞肺癌(NSCLC)的主要有效手段,随着低剂量螺旋CT的广泛应用,越来越多的早期非小细胞肺癌被发现,这为早期肺癌的治疗提供了更多的可能性。解剖性肺叶切除术是目前治疗非小细胞肺癌的标准术式,但随着影像学技术的进步以及临床大夫对于肺部解剖的不断探索,目前已有部分研究显示,早期非小细胞肺癌患者行肺段切除术是安全可行的。但是由于肺段切除术的切除范围要小于肺叶切除术,这可能使得术后复发或者转移的风险增高。随着新辅助治疗的不断发展,已经有研究证实,新辅助治疗可以降低肺癌术后复发和转移的风险。但是,最终能给病人带来多大的生存获益仍需长期的随访和大量的临床试验来验证。

Surgical resection is the main effective means for the treatment of non-small cell lung cancer, and with the wide application of low-dose spiral CT, more and more early non-small cell lung cancer has been found, which provides more possibilities for the treatment of early lung cancer. Anatomical lobectomy is currently the standard surgical procedure for the treatment of non-small cell lung cancer. However, with the progress of imaging technology and the continuous exploration of lung anatomy by clinicians, some studies have shown that segmental resection is safe and feasible for patients with early stage non-small cell lung cancer. However, since segmental resection is less extensive than lobectomy, it may increase the risk of postoperative recurrence or metastasis. With the continuous development of neoadjuvant therapy, studies have confirmed that neoadjuvant therapy can reduce the risk of postoperative recurrence and metastasis of lung cancer. However, long-term follow-up and extensive clinical trials are needed to determine the ultimate survival benefit.