《2010ESMO临床实践指南：早期和局部晚期（非转移性）非小细胞肺癌》内容预览

introduction

Lung cancer represents the leading cause of cancer mortalityworldwide, accounting for 1.2 million deaths each year.Improving survival in lung cancer is a major challenge formodern oncology considering that 5-year survival remains<15%, across all stages of disease and with <7% of patients alive10 years after diagnosis.

Because of the difficulties in significantly improving survival inlocally advanced and metastatic non-small-cell lung cancer(NSCLC), diagnosis and treatment of early stages theoreticallyrepresent the most consistent possibility of modifying theoutcome of NSCLC in terms of disease-free and overall survival.

lung cancer screening and stagingThe large majority of NSCLC patients present with symptomsin a late advanced stage and diagnosis occurs mostly in locallyadvanced or metastatic disease with a very poor rate of cure.The issue of lung cancer screening has consequently a strongrationale, to increase the detection of early NSCLC potentiallycured by surgery. Earlier controlled trials, using standardradiography and sputum cytology failed to demonstrate anysurvival benefit for early detection in the interventional armversus controls. Subsequently using more sensitive screeningmodalities such as low-dose CT scanning (LDCT) severalauthors have demonstrated the possibility of detectingapproximately three times as many small lung nodules incomparison with chest X-ray and of finding early stage lungcancers.

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