Chemotherapy can be used to prolong the life span
Chemotherapy for small cell lung cancer
In the past two decades, the development of chemotherapy for tumor has been rapid and widely used, and from the current domestic and foreign data, the efficacy of chemotherapy for small cell lung cancer, no matter in early stage or in late stage is more certain, and even there are a few reports on the eradication of small cell lung cancer, and there is also a certain efficacy of non-small cell lung cancer, but only for non-small cell lung cancer. The efficacy of chemotherapy on non-small cell lung cancer is also certain, but it is only palliative and needs to be further improved. In recent years, the role of chemotherapy in lung cancer is no longer limited to inoperable advanced lung cancer, but is often included in the comprehensive treatment of lung cancer as systemic therapy. Chemotherapy for small-cell lung cancer Due to the biological characteristics of small-cell lung cancer, it is recognized that chemotherapy should be preferred except for a few patients without intrathoracic lymph node metastasis. Indications (1) Patients with small cell lung cancer diagnosed by pathology or cytology. (2) Those with KS score above 50-60. (3) Those with expected survival time of more than one month. (4) Age ≤70 years old. 2. Contraindications (1) Those who are old and weak or malignant. (2) Those with serious dysfunction of heart, liver and kidney. (3) Poor bone marrow function, white blood cells below 3 × 109 / L, platelets below 80 × 109 / l (direct count). (4) Complications and infections, fever, bleeding tendency, etc. 3. Commonly used program: except for special circumstances, monotherapy is generally not used. The more effective programs recommended by the international and national collaborative groups in clinical practice are: (1) CAO (Shanghai Chest Hospital): cyclophosphamide 1000mg/m2 intravenous injection, the first day of Adriamycin 50-60mg/m2 intravenous injection, the first day of Vincristine 1mg/m2 intravenous injection, the first day of the first day (2-3 weeks of treatment for a period of 3 weeks). -(2) COMVP (National Society of Chemotherapy Collaborative Protocol): cyclosporine 500-700mg/m2 IV on days 1 and 8, vincristine 1mg/m2 IV on days 1 and 8, methotrexate 7-14mg/m2 IV or intramuscular on days 3, 5, 10, and 12, and vinblastine 1mg/m2 IV on days 1, 2, 3, 3, and 4. ECHO (M, D, Auderson Hospital and Institute of Oncology): Ghrelin 100mg, IV drip (3 hours), days 3-5 Cyclosporine 1000g/m2 IV drip (3 hours), days 3-5 Cyclosporine 1000g/m2 IV drip (3 hours), days 3-5 Cyclosporine 1000g/m2 IV drip (3 hours), days 3-5 Cyclosporine 1000g/m2 IV drip (3 hours), days 3-5 Cyclosporine 1000g/m2 IV drip (days 3-5 Cyclosporine 1000g/m2 IV drip (days 3-5) Cyclosporine 1000g/m2 IV drip (days 1, 8) Cyclosporine 1mg/m2 IV drip (days 1, 8) m2 IV drip (1 hour) day l Adriamycin 60mg/m2 IV drip (15-30 min) day l Vincristine lmg/m2 IV drip (15-30 min) days 1 and 8 Every 3 weeks as a cycle, 3 cycles as a course of treatment (4). CMC (NCI/VA Shanghai Chest Hospital): squamous amides 500mg/m2 IV injection CMC (NCI/VA Shanghai Chest Hospital): squamous amide 500mg/m2 IV, once weekly x3 or 1000-1500mg/m2 IV, day 2 CCNU 50-70mg/m2 orally on an empty stomach, night 1 Amethotrexate 10mg/m2 IV twice weekly x6 or 30mg/m2 day 2 Every three weeks for one cycle, 2-3 cycles for one course of treatment. (5) CV (I, E Smith, 1987): carboplatin (carboplatin), carboplatin (carboplatin), carboplatin (carboplatin), carboplatin (carboplatin), carboplatin (carboplatin), carboplatin (carboplatin), carboplatin (carboplatin), carboplatin) Carboplatin (carboplatin) 300mg / m2, intravenous drip, day l Gemcitabine 100mg / m2, intravenous drip, days 1 to 3 every 4 weeks for a cycle, 4 cycles for a course of treatment Pre-operative and post-operative chemotherapy, for the patients who can be operated on or have surgical conditions after shrinking of the mass with chemotherapy, the primary foci should be excised as far as possible to remove the possibility of local recurrence. Preoperative chemotherapy is generally appropriate for 2 to 3 courses of treatment to prevent the lesion from being under-treated and excessive fibrosis caused by too long a course of treatment, resulting in surgical difficulties. Preoperative chemotherapy should be used for those who have clear intrathoracic lymph node metastasis. Whether preoperative chemotherapy is needed for stage I patients without intrathoracic lymph node metastasis remains to be explored. Postoperative chemotherapy has a greater impact on long-term postoperative survival and must be applied emphatically, generally in favor of more than 4 to 6 cycles of chemotherapy. If chemotherapy is effective, but it is estimated that the surgery can not be clean and intraoperative lesions can not be all cut clean should also be given regional radiation therapy.