Feasibility of Surgery for Advanced NSCLC Treated with Tyrosine Kinase Inhibitors as Neoadjuvant Therapy

晚期非小細胞肺癌應用酪胺酸激酶抑制標靶藥物為前導治療的手術可行性

吳維喬(Wei-Ciao Wu) ； 曾堯麟(Yau-Lin Tseng) ； 顏亦廷(Yi-Ting Yen) ； 賴吾為(Wu-Wei Lai)

《胸腔醫學》 31卷4期 (2016/08) Pp. 236-242

摘要

針對局部晚期非小細胞肺癌使用酪氨酸激酶抑制劑（tyrosine-kinase inhibitors, TKIs）做為前導化療並接續手術切除的治療方式目前仍存在爭議。世界各地現在只有零星的個案報導，對於使用TKIs後手術切除的時機點以及評估哪些病況適合手術切除未能有共識。我們提供10例非小細胞肺癌IIIa期到VI期的病人，以TKIs作為一線治療，然後在能夠達到完全切除或患者無法忍受TKIs副作用時給予手術切除病灶。手術本身的療效和術後存活是可以接受的，而且能夠提示我們未來治療的指引。我們相信可以進行進一步的臨床試驗以評估這種治療方式的效益。

關鍵字

酪氨酸激酶抑制劑 ； 前導治療 ； 非小細胞肺癌

並列摘要

The role of surgical resection after tyrosine-kinase inhibitor (TKI) treatment in locally advanced NSCLC remains controversial. There have benn scanty case reports of successful treatment outcome resulting from complete resection post-TKI response. However, there is no consensus on indication or timing of surgical resection in locally advanced NSCLC treated with TKIs. We present the cases of 10 patients with NSCLC stage IIIa~VI who received TKIs as first-line treatment. Surgical resection was performed in various situations, including those in which complete resection could be achieved and those in which the patient could not withstand the adverse effects of TKI. Surgical outcomes and survival patterns were acceptable. TKIs can be used as neoadjuvant therapy, but further research should indicate the timing of surgery and the criteria of patient selection. We believe future clinical trial should be conducted to evaluate this treatment modality.

並列關鍵字

tyrosine kinase inhibitor ； neoadjuvant ； non small cell lung cancer