The latest international non-small cell lung cancer TNM staging published in 1997. TNM staging is by the so-called primary tumor (T), lymph node metastasis (N), distant metastasis (M) of the situation on the tumor staging, to reflect the extent of the tumor and the severity of the disease, as the development of treatment plans and determine the basis for survival. In 1997 the use of the 5333 cases of staging non-small cell lung cancer prognosis, ie, 1, 3, 5-year survival rate: I stage were 71%, 46%, 25%; IT of 59%, respectively, 30%, 20%; Prisoners A are respectively 50%, 21%, 11%; III B of respectively 43%, 14%, 16% IV period were 33%, 11%, 3%. The median survival time I, N of the order of 930 days, 462 days, 393 days, 282 days, 221 days. As can be seen from the above data is very significant difference between each period, survival was inversely proportional with the stage of disease, with the focus on the shorter of disease. According to pathological findings obtained after surgery of a more accurate staging (PTNM) and similar to the clinical stage. Therefore, due to dry on the diagnosis and staging of Chicago in time to receive formal treatment for the best non-small cell lung cancer treatment.
Symptoms of small cell lung cancer compared with non-small cell lung cancer is generally increasing the longer the corresponding doubling time, sensitivity to chemotherapy and radiation than small cell lung cancer . However, due to transfer time and scope of the histological type and degree of differentiation (such as squamous or adenocarcinoma at high, medium and low of 3) vary. In particular, the lungs showed poorly differentiated adenocarcinoma with resectable early (I or H phase) lesions, they are asymptomatic in the distance there is (such as bone or brain) metastases. even the moderately differentiated adenocarcinoma also have this tendency can not be ignored. Poorly differentiated squamous cell carcinoma has a similar, but not as poorly differentiated adenocarcinoma serious. Hold a large group of cancer also have a tendency to early metastasis. So now that the non-small cell lung cancer is systemic disease, N of the basic treatment of small cell lung cancer with its comprehensive treatment modalities need to be unified.
Comparative clinical study after a large number of identified cis-lead (DDP)-based chemotherapy improve the survival effect of mild, so far) / anti-white advanced non-small cell lung cancer remains one of the drugs of choice. / Anti-self / heterocyclic phosphorus discretion plastic / rubber gaze intently vinblastine and other drugs alone is about 15% efficient, Adriamycin / epirubicin / mitomycin / etoposide trial / full leaf Oh thiophene test / vincristine / vinblastine / 5 – fluorouracil slightly Wan / cyclic plastic and other drugs, single drug effective rate is less than 10%, the drugs combined chemotherapy with cis uranium about 30% effective rate, median survival of about 6 months and 1 year survival rate of 20% -30%.
Over the past decade, especially in the past four years, with the Taxol, Taxotere, to vinorelbine, gemcitabine, topotecan and irinotecan come out and have to enter the Chinese market, to non-small cell patients with lung cancer brought the gospel. Monotherapy these drugs have efficiency of about 20%. And relatively low toxicity, changed the way people in non-small cell lung cancer is not sensitive to chemotherapy, the tumor of the concept. Multiple clinical reports such as gemcitabine monotherapy and Shun lead plus etoposide compared to test the efficiency of joint programs, both in remission and no difference in survival, but far below the toxicity of lead combined etoposide along again. Lead is still the most effective along the treatment of advanced non-small cell lung cancer first-line drugs. Have synergies with the new drug, to shun the Bai-based joint program of a new drug combination therapy about 40% efficient, one year survival rate was 30% _40%, has become the standard first-line treatment programs, significant changes in the non-small cell lung cancer chemotherapy situation. Admittedly, these new drugs is a common drawback is the price too expensive, a considerable proportion of patients to bring a heavy financial burden. The more rational use of its important. In addition, patients are not beyond their economic capacity and over-emphasis on use of these expensive new drugs, because the composition of some of the old drug program has mature experience, can bring good results to patients. If / anti-self / etoposide test or different cyclic plastic / MMC and other joint programs is still the commonly used and effective treatment, and treatment of lung cancer is more in line with China's national conditions.