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根治性切除的非小细胞肺癌(NSCLC)术后辅助化疗曾有争议,对以往的研究分析,辅助化疗的效果令人失望。而2003年开始,几项大规模的临床随机对照研究,包括IALT、CALGB9633、JBR10、ANITA和日本的UFT研究,这些阳性结果逐渐肯定了辅助化疗的地位,通过荟萃分析得出含铂方案的术后辅助化疗使NSCLC患者5年生存率绝对获益4%。目前面临的问题是,如何把辅助化疗的疗效进一步放大而毒副作用进一步降低。通过对一些的生物标记物的检测来预知药物的疗效以指导药物的选择,即“个体化治疗”目前虽还处于探索阶段,但已显出巨大的潜力;分子靶向药物在非手术患者中已取得非凡的成就,是否提示用于术后辅助治疗同样也有效。这一领域未来研究热点可能向这两个方面发展。
Radical resection of non-small cell lung cancer (NSCLC) postoperative adjuvant chemotherapy has been controversial, previous research and analysis, the effect of adjuvant chemotherapy is disappointing. Since 2003, several large-scale randomized controlled clinical studies including IALT, CALGB9633, JBR10, ANITA, and Japan’s UFT have gradually confirmed the status of adjuvant chemotherapy. Meta-analysis showed that platinum-containing surgery Post-adjuvant chemotherapy provides a 4% absolute benefit for 5-year survival in patients with NSCLC. The current problem is how to further enhance the efficacy of adjuvant chemotherapy and further reduce side effects. Through the detection of some biomarkers to predict the efficacy of drugs to guide the choice of drugs, that “individualized treatment ” is still in the exploration stage, but has shown great potential; molecular-targeted drugs in non-surgical Patients have made extraordinary achievements, whether prompted for postoperative adjuvant therapy is also effective. Future research in this area may develop in both directions.