SCI
3 December 2019
Asian Thoracic Oncology Research Group expert consensus statement on optimal management of stage III non-small cell lung cancer
Tan WL, Chua KLM, Lin C-C, et al. Asian Thoracic Oncology Research Group expert consensus statement on optimal management of stage III non-small cell lung cancer. Journal of Thoracic Oncology 2019.
*Corresponding author:Daniel S.W. Tan, Division of Medical Oncology.Address: Division of Medical Oncology, National Cancer Centre Singapore.11 Hospital Drive, Singapore 169610. Tel: (65) 6704 8468; Fax: (65) 6436 8310.Email: daniel.tan.s.w@singhealth.com.sg
Abstract 摘要
Stage III non-small cell lung cancer (NSCLC) represents a heterogeneous disease for which optimal treatment continues to pose a clinical challenge. Recent changes in the American Joint Commission on Cancer (AJCC) staging to the 8th edition has led to a shift in TNM stage grouping and redefined the subcategories (IIIA–C) in stage III NSCLC for better prognostication. Although concurrent chemoradiotherapy (CCRT) has remained standard of care for Stage III NSCLC for almost 2 decades, contemporary considerations include the impact of different molecular subsets of NSCLC, role of tyrosine kinas inhibitors (TKIs) post-definitive therapy, and of immune checkpoint inhibitors following chemoradiotherapy.
III期非小细胞肺癌(NSCLC)是一种复杂疾病，其最佳临床治疗仍存在争议。美国癌症联合委员会(American Joint Commission on Cancer, AJCC)对第8版癌症分期的最新变化改变了TNM分期，并重新定义了III期NSCLC的亚组(IIIA-C)，以便更好地预测预后。虽然近20年来同步放化疗(CCRT)一直是III期NSCLC的标准治疗方法，但当前已经将包括NSCLC不同分子亚群的影响、酪氨酸激酶抑制剂(TKIs)的作用、放化疗后免疫检查点抑制剂的作用等因素考虑在内。
With rapid evolution of diagnostic algorithms and expanding treatment options, the need for interdisciplinary input –involving multiple specialists (medical oncologists, pulmonologists, radiologists and thoracic surgeons) has become increasingly important. The unique demographics of Asian NSCLC pose further challenges when applying clinical trial data into clinical practice. This includes differences in smoking rates, prevalence of oncogenic driver mutations, and access to healthcare resources including molecular testing, prompting the need for critical review of existing data and identification of current gaps.
随着诊断算法的快速发展和治疗方案的不断扩展，多学科输入的需求——包括多科专家(医学肿瘤学家、肺科医生、放射科医生和胸外科医生)——变得越来越重要。在将临床试验数据应用于临床实践时，亚洲非小细胞肺癌独特的人口统计学特征带来了进一步的挑战。这包括吸烟率的差异、致癌驱动突变的流行以及获得包括分子检测在内的医疗保健资源的途径，使我们需要对现有数据进行批判性审查并确定当前的差距。
In this expert consensus statement by the Asian Thoracic Oncology Research Group (ATORG), an interdisciplinary group of experts representing Hong Kong, Korea, Japan, Taiwan, Singapore, Thailand, Malaysia and Mainland China was convened. Standard clinical practices for stage III NSCLC across different Asian countries were discussed from initial diagnosis, staging through to multi-modality approaches including surgery, chemotherapy, radiation, targeted therapies and immunotherapy.
香港、韩国、日本、台湾、新加坡、泰国、马来西亚和中国大陆的专家组成的跨学科专家组参会，亚洲胸部肿瘤研究组(ATORG)发表了此份专家共识。我们讨论了亚洲各国III期NSCLC的标准临床实践，从最初的诊断、分期到手术、化疗、放疗、靶向治疗和免疫治疗等多种方式。
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