• 卵巢癌這樣治,可以減少很多痛苦

        卵巢癌這樣治,可以減少很多痛苦

      • 兄妹相繼患癌,它讓癌癥治愈成為可能

        兄妹相繼患癌,它讓癌癥治愈成為可能

      • 晚期肝癌患者吐血不止,是什么治療將他從肝癌死神手上搶回?

        晚期肝癌患者吐血不止,是什么治療將他從肝癌死神手上搶回?

      • 肝癌晚期的治療,抗癌5年這個治療卻讓他1個月消除腫瘤

        肝癌晚期的治療,抗癌5年這個治療卻讓他1個月消除腫瘤

      • 肝癌的治療方法,多次復發是不是只能開刀換肝了?

        肝癌的治療方法,多次復發是不是只能開刀換肝了?

      • 肝癌的治療奇跡,一次治療痊愈后,他化身抗肝癌大使

        肝癌的治療奇跡,一次治療痊愈后,他化身抗肝癌大使

      • 肺癌晚期能治好嗎,不開刀、不放化療他是怎么治愈成功的?

        肺癌晚期能治好嗎,不開刀、不放化療他是怎么治愈成功的?

      • 肺癌晚期怎么治,六旬老人的肺癌成功治愈自述

        肺癌晚期怎么治,六旬老人的肺癌成功治愈自述

      您當前的位置: 首頁 > 腫瘤歸類 > 呼吸系統腫瘤 > 肺癌

        姚波醫生,非小細胞肺癌晚期或轉移性疾病的全身治療2017V4

      • 全網發布:2021-05-02 07:15:02 發表者: x2admin

      SYSTEMIC THERAPY FOR ADVANCED OR METASTATIC DISEASE 早期或者轉移性疾病的滿身醫治

      ADVANCED DISEASE: 早期疾病山東省腫瘤病院呼吸外科張品良

      * The drug regimen with the highest likelihood of benefit with toxicity deemed acceptable to both the physician and the patient should be given as initial therapy for advanced lung cancer. 該當賜與最能夠受害的、毒性對于醫患單方均可承受的藥物計劃作為早期肺癌的初始醫治。

      * Stage, weight loss, performance status, and gender predict survival. 分期、體重加重、普通狀況和性別猜測生活。

      * Platinum-based chemotherapy prolongs survival, improves symptom control, and yields superior quality of life compared to best supportive care. 與最好撐持醫治比擬,以鉑類為根底的化療延伸生活期、進步病癥把持率并可取得更好的糊口品質。

      * Histology of NSCLC is important in the selection of systemic therapy. 正在滿身醫治的挑選方面非小細胞肺癌的構造學是緊張的。

      * New agent/platinum combinations have generated a plateau in overall response rate (≈ 25%–35%), time to progression (4–6 mo), median survival (8–10 mo), 1-year survival rate (30%–40%), and 2-year survival rate (10%–15%) in it patients. 患者承受新藥/鉑二聯的療效有個平臺:總無效率(≈25%–35%)、至停頓工夫(4–6個月)、中位生活期(8–10個月)、1年生活率(30%–40%)、2年生活率(10%–15%)。

      * Unit patients of any age (performance status 3–4) do not benefit from cytotoxic treatment, except erlotinib, afatinib, or gefitinib for EGFR mutation-positive and crizotinib for ALK-positive tumors of nonsquamous NSCLC or NSCLC NOS. PS 3–四、任何春秋段的患者均不克不及從細胞毒性醫治中獲益,除厄洛替尼、阿法替尼或者吉非替尼用于醫治EGFR漸變陰性以及克唑替尼用于醫治ALK陰性的非鱗非小細胞肺癌或者非小細胞肺癌非特指患者。

      First-line Therapy 一線醫治

      * There is superior efficacy and reduced toxicity for cisplatin/pemetrexed in patients with nonsquamous histology, in comparison to cisplatin/gemcitabine. 正在構造學非鱗癌患者中,與順鉑/吉西他濱比擬,順鉑/培美曲塞有良好的療效以及較低的毒性。

      * There is superior efficacy for cisplatin/gemcitabine in patients with squamous histology, in comparison to cisplatin/pemetrexed. 正在構造學鱗癌患者中,與順鉑/培美曲塞比擬,順鉑/吉西他濱有良好的療效。

      * Two drug regimens are preferred; a third cytotoxic drug increases response rate but not survival. Single-agent therapy may be appropriate in select patients. 首選兩藥計劃;第3個細胞毒藥物添加無效率,但沒有改進生活。正在挑選性的患者中單藥醫治能夠是公道的。

      * Response assessment after 2 cycles, then every 2–4 cycles with CT of known sites of disease with or without contrast or when clinically indicated. 兩周期后評價療效,而后每一2-4周期或者有臨床指征時對于已經知部位強化或者平掃CT反省。

      Maintenance Therapy 保持醫治

      * Continuation maintenance refers to the use of at least one of the agents given in first line, beyond 4–6 cycles, in the absence of disease progression. Switch maintenance refers to the initiation of a different agent, not included as part of the first-line regimen, in the absence of disease progression, after 4–6 cycles of initial therapy. 持續保持醫治是指正在4至6周期后疾病無停頓者,運用至多一種一線賜與的藥物。轉換保持醫治是指正在4-6周期初始醫治后疾病無停頓者,啟動一線計劃中沒有包括的另外一個差別的藥物。

      Subsequent Therapy 后續醫治

      * Response assessment with CT of known sites of disease with or without contrast every 6–12 weeks. 每一6-12周對于已經知病變部位強化或者平掃CT反省評價療效。

      See First-line Systemic Therapy Options for Adenocarcinoma, Large cell, NSCLC NOS on NSCL-F (2 of 4) 見NSCL-F(2/4)腺癌、大細胞癌、非特指非小細胞肺癌的一線滿身醫治計劃。

      See First-line Systemic Therapy Options for Squamous Cell Carcinoma on NSCL-F (3 of 4)見NSCL-F(3/4)鱗狀細胞癌的一線滿身醫治計劃

      SYSTEMIC THERAPY FOR ADVANCED OR METASTATIC DISEASE+ 早期或者轉移性疾病的滿身醫治

      First-line Systemic Therapy Options 一線滿身醫治計劃

      Adenocarcinoma, Large Cell, NSCLC NOS (PS 0-1)腺癌、大細胞肺癌、非小細胞肺癌非特指(PS 0-1)

      * Bevacizumab/carboplatin/paclitaxel (category 1),*,**,*** 貝伐單抗/卡鉑/紫杉醇(1類)

      * Bevacizumab/carboplatin/pemetrexed,*,**,*** 貝伐單抗/卡鉑/培美曲塞

      * Bevacizumab/cisplatin/pemetrexed*,**,*** 貝伐單抗/順鉑/培美曲塞

      * Carboplatin/albumin-bound paclitaxel (category 1) 卡鉑/白卵白分離型紫杉醇(1類)

      * Carboplatin/docetaxel (category 1)卡鉑/多西他賽(1類)

      * Carboplatin/etoposide (category 1) 卡鉑/依靠泊苷(1類)

      * Carboplatin/gemcitabine (category 1) 卡鉑/吉西他濱(1類)

      * Carboplatin/paclitaxel (category 1) 卡鉑/紫杉醇(1類)

      * Carboplatin/pemetrexed (category 1) 卡鉑/培美曲塞(1類)

      * Cisplatin/docetaxel (category 1) 順鉑/多西他賽(1類)

      * Cisplatin/etoposide (category 1) 順鉑/依靠泊苷(1類)

      * Cisplatin/gemcitabine (category 1) 順鉑/吉西他濱(1類)

      * Cisplatin/paclitaxel (category 1) 順鉑/紫杉醇(1類)

      * Cisplatin/pemetrexed (category 1) 順鉑/培美曲塞(1類)

      * Gemcitabine/docetaxel (category 1) 吉西他濱/多西他賽(1類)

      * Gemcitabine/vinorelbine (category 1) 吉西他濱/長春瑞濱(1類)

      Adenocarcinoma, Large Cell, NSCLC NOS (PS 2)腺癌,大細胞肺癌,非小細胞肺癌非特指(PS 2)

      * Albumin-bound paclitaxel 白卵白分離型紫杉醇

      * Carboplatin/albumin-bound paclitaxel 卡鉑/白卵白分離型紫杉醇

      * Carboplatin/docetaxel 卡鉑/多西他賽

      * Carboplatin/etoposide 卡鉑/依靠泊苷

      * Carboplatin/gemcitabine 卡鉑/吉西他濱

      * Carboplatin/paclitaxel 卡鉑/紫杉醇

      * Carboplatin/pemetrexed卡鉑/培美曲塞

      * Docetaxel 多西他賽

      * Gemcitabine 吉西他濱

      * Gemcitabine/docetaxel 吉西他濱/多西他賽

      * Gemcitabine/vinorelbine 吉西他濱/長春瑞濱

      * Paclitaxel 紫杉醇

      * Pemetrexed 培美曲塞

      +Albumin-bound paclitaxel may be substituted for either paclitaxel or docetaxel in patients who have experienced hypersensitivity reactions after receiving paclitaxel or docetaxel despite premedication, or for patients where the standard premedications (ie, dexamethasone, H2 blockers, H1 blockers) are contraindicated. 正在承受紫杉醇或者多西他賽的患者中,雖然預處置用藥仍有過敏反響者,或者規范預處置用藥(即地塞米松、H2受體停滯劑、H1受體停滯劑)忌諱者,白卵白分離型紫杉醇能夠代替紫杉醇或者多西他賽。

      *Bevacizumab should be given until progression. 該當賜與貝伐單抗直至疾病停頓。

      **Any regimen with a high risk of thrombocytopenia and the potential risk of bleeding should be used with caution in combination with bevacizumab. 任何具備血小板增加高危以及潛伏出血危害的計劃,結合貝伐單抗時均應慎重。

      ***Criteria for treatment with bevacizumab: non-squamous NSCLC, and no recent history of hemoptysis. Bevacizumab should not be given as a single agent, unless as maintenance if initially used with chemotherapy.結合貝伐單抗是規范醫治:非鱗非小細胞肺癌而且近期無咯血史。貝伐單抗不該單藥賜與,除了非最后結合化療運用而后作為保持。

      SYSTEMIC THERAPY FOR ADVANCED OR METASTATIC DISEASE+早期或者轉移性疾病的滿身醫治

      First-line Systemic Therapy Options 一線滿身醫治計劃

      Adenocarcinoma, Large Cell, NSCLC NOS (PS 0-1) 腺癌、大細胞肺癌、非小細胞肺癌非特指(PS 0-1)

      * Bevacizumab/carboplatin/paclitaxel (category 1),*,**,*** 貝伐單抗/卡鉑/紫杉醇(1類)

      * Bevacizumab/carboplatin/pemetrexed,*,**,*** 貝伐單抗/卡鉑/培美曲塞

      * Bevacizumab/cisplatin/pemetrexed*,**,*** 貝伐單抗/順鉑/培美曲塞

      * Carboplatin/albumin-bound paclitaxel (category 1) 卡鉑/白卵白分離型紫杉醇(1類)

      * Carboplatin/docetaxel (category 1) 卡鉑/多西他賽(1類)

      * Carboplatin/etoposide (category 1) 卡鉑/依靠泊苷(1類)

      * Carboplatin/gemcitabine (category 1) 卡鉑/吉西他濱(1類)

      * Carboplatin/paclitaxel (category 1) 卡鉑/紫杉醇(1類)

      * Carboplatin/pemetrexed (category 1) 卡鉑/培美曲塞(1類)

      * Cisplatin/docetaxel (category 1) 順鉑/多西他賽(1類)

      * Cisplatin/etoposide (category 1)順鉑/依靠泊苷(1類)

      * Cisplatin/gemcitabine (category 1) 順鉑/吉西他濱(1類)

      * Cisplatin/paclitaxel (category 1) 順鉑/紫杉醇(1類)

      * Cisplatin/pemetrexed (category 1) 順鉑/培美曲塞(1類)

      * Gemcitabine/docetaxel (category 1) 吉西他濱/多西他賽(1類)

      * Gemcitabine/vinorelbine (category 1) 吉西他濱/長春瑞濱(1類)

      Adenocarcinoma, Large Cell, NSCLC NOS (PS 2) 腺癌,大細胞肺癌,非小細胞肺癌非特指(PS 2)

      * Albumin-bound paclitaxel 白卵白分離型紫杉醇

      * Carboplatin/albumin-bound paclitaxel 卡鉑/白卵白分離型紫杉醇

      * Carboplatin/docetaxel 卡鉑/多西他賽

      * Carboplatin/etoposide 卡鉑/依靠泊苷

      * Carboplatin/gemcitabine 卡鉑/吉西他濱

      * Carboplatin/paclitaxel 卡鉑/紫杉醇

      * Carboplatin/pemetrexed 卡鉑/培美曲塞

      * Docetaxel 多西他賽

      * Gemcitabine 吉西他濱

      * Gemcitabine/docetaxel 吉西他濱/多西他賽

      * Gemcitabine/vinorelbine 吉西他濱/長春瑞濱

      * Paclitaxel 紫杉醇

      * Pemetrexed 培美曲塞

      +Albumin-bound paclitaxel may be substituted for either paclitaxel or docetaxel in patients who have experienced hypersensitivity reactions after receiving paclitaxel or docetaxel despite premedication, or for patients where the standard premedications (ie, dexamethasone, H2 blockers, H1 blockers) are contraindicated. 正在承受紫杉醇或者多西他賽的患者中,雖然預處置用藥仍有過敏反響者,或者規范預處置用藥(即地塞米松、H2受體停滯劑、H1受體停滯劑)忌諱者,白卵白分離型紫杉醇能夠代替紫杉醇或者多西他賽。

      *Bevacizumab should be given until progression. 該當賜與貝伐單抗直至疾病停頓。

      **Any regimen with a high risk of thrombocytopenia and the potential risk of bleeding should be used with caution in combination with bevacizumab. 任何具備血小板增加高危以及潛伏出血危害的計劃,結合貝伐單抗時均應慎重。

      ***Criteria for treatment with bevacizumab: non-squamous NSCLC, and no recent history of hemoptysis. Bevacizumab should not be given as a single agent, unless as maintenance if initially used with chemotherapy.結合貝伐單抗是規范醫治:非鱗非小細胞肺癌而且近期無咯血史。貝伐單抗不該單藥賜與,除了非最后結合化療運用而后作為保持。

      First-line Systemic Therapy Options 一線滿身醫治計劃

      Squamous Cell Carcinoma (PS 0-1) 鱗狀細胞癌(PS 0-1)

      * Carboplatin/albumin-bound paclitaxel (category 1) 卡鉑/白卵白分離型紫杉醇(1類)

      * Carboplatin/docetaxel (category 1) 卡鉑/多西他賽(1類)

      * Carboplatin/gemcitabine (category 1) 卡鉑/吉西他濱(1類)

      * Carboplatin/paclitaxel (category 1) 卡鉑/紫杉醇(1類)

      * Cisplatin/docetaxel (category 1)順鉑/多西他賽(1類)

      * Cisplatin/etoposide (category 1)順鉑/依靠泊苷(1類)

      * Cisplatin/gemcitabine (category 1) 順鉑/吉西他濱(1類)

      * Cisplatin/paclitaxel (category 1) 順鉑/紫杉醇(1類)

      * Gemcitabine/docetaxel (category 1) 吉西他濱/多西他賽(1類)

      * Gemcitabine/vinorelbine (category 1)吉西他濱/長春瑞濱(1類)

      Squamous Cell Carcinoma (PS 2) 鱗狀細胞癌(PS 2)

      * Albumin-bound paclitaxel 白卵白分離型紫杉醇

      * Carboplatin/albumin-bound paclitaxel 卡鉑/白卵白分離型紫杉醇

      * Carboplatin/docetaxel 卡鉑/多西他賽

      * Carboplatin/etoposide 卡鉑/依靠泊苷

      * Carboplatin/gemcitabine 卡鉑/吉西他濱

      * Carboplatin/paclitaxel 卡鉑/紫杉醇

      * Docetaxel 多西他賽

      * Gemcitabine 吉西他濱

      * Gemcitabine/docetaxel 吉西他濱/多西他賽

      * Gemcitabine/vinorelbine 吉西他濱/長春瑞濱

      * Paclitaxel 紫杉醇

      +Albumin-bound paclitaxel may be substituted for either paclitaxel or docetaxel in patients who have experienced hypersensitivity reactions after receiving paclitaxel or docetaxel despite premedication, or for patients where the standard premedications (ie, dexamethasone, H2 blockers, H1 blockers) are contraindicated. 正在承受紫杉醇或者多西他賽的患者中,雖然預處置用藥仍有過敏反響者,或者規范預處置用藥(即地塞米松、H2受體停滯劑、H1受體停滯劑)忌諱者,白卵白分離型紫杉醇能夠代替紫杉醇或者多西他賽。

      ++Cisplatin/gemcitabine/necitumumab in the first-line setting and erlotinib or afatinib in the second-line setting are not used at NCCN institutions for these indications related to the efficacy and safety of these agents compared to the efficacy and safety of other available agents.正在NCCN機構中關于這些順應癥,基于這些藥物的療效與平安性以及其余可用藥物的療效與平安性比擬較,順鉑/吉西他濱/奈昔妥珠單抗不必于一線、厄洛替尼或者阿法替尼不必于二線。

      權威專家
      • 姚波教授
        國內著名腫瘤內科專家、主任醫師、國家二級教授...詳細>>
      • 周鴻灝院士
        中國工程院院士...詳細>>
      • 柴樹德教授
        柴樹德教授是國際著名消化病專家和腫瘤治療專家...詳細>>
      • 宋于剛教授
        國內著名胸部腫瘤外科專家、主任醫師、教授...詳細>>
      治療方案
      欧美福利电影a在线播放