2022年医学专题—同步放化疗肺癌中文版(1).pptVIP免费

ManagementofunresectablestageⅢnon-smallcelllungcancer:theroleofcombinedchemoradiation第一页，共二十九页。introductionUntilthelate1980s,thoracicradiationtherapy(TRT)remainedthestandardcareforlocallyadvancedNSCLC.第二页，共二十九页。Radiationalone?Sequentialchemoradiation?第三页，共二十九页。CALGB8433RT60GyPV2cycles＋RT60GyNo.7779MST9.713.81-yearsurvival40552yearsurvival13263yearsurvival11235yearsurvival719Pvalue0.0066DillmanRO,NEJM323:940-945,1990DillmanRO,JNCI88:1210-1215,1996第四页，共二十九页。RTOG8808RT60GyCT+RTH-RT69.6GyNo152152154MST11.413.2121-yearsurvival4759522-yearsurvival2132243-yearsurvival1117145-yearsurvival6119Pvalue0.04SauseW,JNCI1995;87:198-205SauseW,CHEST2000;117:358-364第五页，共二十九页。OS第六页，共二十九页。<60ysurvival第七页，共二十九页。FRANCERT65GyCT+RT65GyP值No177176MST10120.081-yearsurvival41502-yearsurvival14213-yearsurvival511Metastasisrate3826<0.0011-yearLCR1715ThierryLeChevaliar,JNCI1991;83:417-423CT:VCPC,vindesine,cyclophosphamide,cisplatin,lomustine第八页，共二十九页。Concurrentchemoradiation?Radiationalone?第九页，共二十九页。EORTCRT55PDD(W)+RTPDD(D)+RTNo3113113111-ysurvival4644542-ysurvival1319263-ysurvival21316Pvalue0.0091-yLCR193031Pvalue0.003Schaake-KoningC,NEJM1992;326:524-530第十页，共二十九页。IntensifiedregimenH-RTH-RT/CTH-RT/CTNo615256methods64.8Gy64.8/CE64.8/CEMST818133-ysurvival6.62316JeremicB,JCO1995;13:452-458LeeJS,JCO1994;14:1055-1064CT:weekly,100mg/m2CBPD1,D2;100mg/m2VP-16D1-3CT:200mg/m2CBPD1,D2;100mg/m2VP-16D1-5,thefirst,third,andfifthweeks第十一页，共二十九页。MetaAnalysisResults(52trials,9387pts)2-yearsurvival4%。Hazardratio:0.87。NSCLCCG,BMJ1995;311:899-909第十二页，共二十九页。Concurrentchemoradiation?Sequentialchemoradiation?第十三页，共二十九页。concurrentsequentialPvalueNo156158methods56Gy/MVP2CMVP2C+56MST16.513.30.042-ysurvival34.627.43-ysurvival22.314.74-ysurvival16.910.15-ysurvival15.88.9ResponseR84660.0002FuruseK,JCO1999;17:2692-2699Japan第十四页，共二十九页。RTOG9410sequentialconcurrentconcurrent...