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非小细胞肺癌(NSCLC)约占肺癌总数的80％。70％NSCLC为预后不良的Ⅲ和Ⅳ期病变。对这些晚期病变中不能手术切除者的最适宜处理一直存有众多争议。为此美国临床肿瘤学会组逮一个专家小组,对1997年4月以前有关的文献进行了全面细致地复习和审慎客观地评议,于1997年5月16日通过了“不能切除的NSCLC临床处理准则”。 1.晚期肺癌病人的诊断性评估:①局部病变分期,推荐以胸部X线检查和胸部(下界包括肝和肾上腺)造影剂强化CT扫描行病变分期:在能手术的NSCLC病人,推荐对CT发现纵隔淋巴结最小横径大于1.0cm者行活检。②远隔转移什病变分期,对主诉骨痛或胸痛,或血清钙水平升高或血清碱性磷酸酶水平升高者应行骨
Non-small cell lung cancer (NSCLC) accounts for about 80% of the total number of lung cancers. 70% of NSCLC is a poor prognosis of stage III and IV lesions. There has been considerable controversy over the optimal treatment of those who cannot undergo surgical resection in these advanced lesions. For this reason, the American Society of Clinical Oncology Group arrested a group of experts and conducted a thorough and prudent review of the relevant literature before April 1997. On May 16, 1997, it adopted the “unresectable guidelines for clinical treatment of NSCLC. ". 1. Diagnostic evaluation of patients with advanced lung cancer: 1 local lesion stage, chest X-ray examination and chest (lower border including liver and adrenal gland) contrast agent for enhanced CT scan are recommended for staged lesions: in patients with operable NSCLC, CT findings are recommended Biopsy was performed when the median diameter of mediastinal lymph nodes was greater than 1.0 cm. 2 Distant metastasis and staging of disease, bone pain or chest pain for the chief complaint, or elevated serum calcium or elevated serum alkaline phosphatase levels should be performed