טיפול משולב לסרטן הריאה

Analysis: Three-Way Punch to Lung Cancer By ED SUSMAN Doctors said Monday that radiation treatment combined with chemotherapy after lung cancer surgery can double the survival time for patients with cancer that hasn't yet spread through the body. In this study 47 patients with lung cancer survived for at least five years, said Jean-Yves Douillard, professor AND head of medical oncology at Centre Rene Gouducheau, Nantes, France. The researchers examined outcomes of 830 French patients who underwent treatment for non-small cell lung cancer, scrutinizing whether treatment with chemotherapy, radiation, the combination of both OR now follow-up therapy is appropriate in patients who have been detected with early-stage lung cancer. For patients with N2 lung cancer -- a condition in which the cancer has spread to lymph nodes in the chest wall -- treatment with surgery to remove the main cancer AND some of those lymph nodes alone results in a dismal 16.6 percent of patients surviving for five years. However, in a press briefing at the 48th annual meeting of the American Society of Therapeutic Radiology AND Oncology in Philadelphia, Douillard told United Press International that by adding radiation therapy alone, that survival for five years can be increased to more than 20 percent. Chemotherapy alone will mean about 34 percent of patients can survive five years, he said. AND chemotherapy AND radiation gives us a 47.4 percent survival after five years. That actually adds more than 24 months of survival to these patients who typically died from lung cancer two years after surgery, Douillard said. This is the way that we build on success in treating cancer over the years, said Theodore Lawrence, professor AND chairman of the department of radiation oncology at the University of Michigan, Ann Arbor, who chaired the press briefing. He noted that over the last decade, improvements in treatments AND technology have gradually produced longer lasting results in treatment. Douillard said that, just because the triple combination of surgery, chemotherapy AND radiation works in some cancer patients, for other patients that kind of treatment may be too much therapy. For example in patients with N0 disease -- lung cancer caught before any of the lymph nodes have been exposed to the cancer -- surgery alone is the best approach. If we have patients with this disease, AND we are finding more AND more patients like this through early screening, we can tell them that we are just going to do surgery AND they can then go home, Douillard told UPI. In the trial, 62.3 percent of patients who underwent surgery for N0 lung cancer survived for at least five years. However, Douillard said that treating these patients with chemotherapy AND radiation after surgery resulted in reduced survival. The study reviewed medical records of patients, AND because of its retrospective nature, may have missed some key elements that could explain why added treatments aren't successful, Lawrence told UPI. Perhaps some of the N0 patients had cancer intruding into the chest wall AND received radiation AND chemotherapy because doctors were concerned about the extent of the disease, he speculated. That might mean the doctors were giving more treatment because the case was more serious. Lawrence said that kind of question should be answered in a prospective, clinical trial. Douillard concurred that his findings need to be confirmed with such a study. Story from REDORBIT NEWS: http://www.redorbit.com/news/display/?id=721330 Published: 2006/11/07 00:01:24 CST

שלום רב, הסיכום שהובא מראה את הבעיתיות של סרטן ריאה ואת אופן ההתייחסות למחקרים שונים. רפואה הוא מדע בו הצטברות הידע היא הדרגתית . אם אנסה לסכם את הגישה המקובלת היום, באופן כללי: כיום מקובל לתת טיפול משולב בהקרנה וכימותרפיה רק בחולים בשלב III, כלומר כאשר יש מעורבות בלוטות לימפה במדיאסטינום (מרכז בית החזה). בשלב II, כאשר אין מעורבות לימפה במדיאסטינום אלא רק בשער הריאה - מקובל לתת כימותרפיה לאחר הניתוח, ללא הקרנות. בשלב I - כאשר אין מעורבות בלוטות - רק חלק מהחולים מקבלים כימותרפיה, והשאר אינה מקבלים. בברכה