常见实体瘤化疗方课件整理

常见实体瘤化疗方案选择湖南省肿瘤医院罗以主要内容非小细胞肺癌大肠癌■乳腺癌■恶性淋巴瘤非小细胞肺癌Oncology-v.1.2019Non-SmallCellLungCancerndentsStagingTeble1.RevisedStageGroupingofTNMSubsets'tT2TumorwithanyofthefolowingfeaturesofsizeorexentMorethan3cmingreatestdimensionNMSubsetStageTNMSubsetImoyosmainbronchus.2cmormoredistaltothecarinaT1.NO,M0N1MAssociatedwithatelectasisorobstructwepneumonitisthalT4,N2,MOextendstothohilarregionbutdoosnotinvoletheentirelungT3Tumorofenysizethatdirectlyinvadesanyofthefollowing:chestwallndudingsuperorsulcustumors),diaphragm,mediastinalT4N3MOAnyT,anyN,Mtisoftheentirelung4Tumorofaryazthatinvadesarclthefollowingmediastinumheart,grestvassals,trachea,esophagus,vertebralbody.carina;orslagingsnotreavantlaroccutcarcinomadasnslsTx,NO,MoseparatetumornodulesinthesamelobeortumorwithamalgnanttUnedwhhthepsrmiaRianofthaAnOntCommitsonCancer(ACC)uml,SizthEdition(2019)pubiahadbyspinaVatiaNewRegionalLymphNodes(NXRegionallymphnodeNoNoregonalNmphnoomotastass1Metastasetoipsilateralpenbronchalandoripsdatealhilarlymphdos,andintrapulmonarynodesindudinginvolomonbydirectTeble2.RevisedDefinitionof"LensionoftheprimarytumorPrimaryTurmormbythepresenceofmalignantcesinsputumorbronchialwashingsbutnotN3Metastasistocontralateralmediastinal,contralateralhiavisualzndbyimagingorbronchoscopypslateralorcontralateralscalene,orsupraclavicularlymphnode(s)DistantMetastasis(M)fisCarcinomainsituT1Tumor3cmorMXDistantmetastesiscannotbeassessedvisceralpleura,wthoutbronchoscopecevidenceofinvasionmoMoNodstanmetastasisproximalthanthelotarbronchus(u,notnthemainbronchusM1DistantmetastasispresentsContinued0e界,DOi是T白图,以的以贴w“知响8T41Lung(Non-SmallCellCarcinomasT1NOIIABBAJIBIA刂BJIAAABN3M1四组化疗方案对晚期初治NSCLC患者效果的比较Kubota,KarmanosCRC(Abstract7106,2000.10-2019.6RegimenDrugdosesandRRMedianMedianOneYearOS(%)schedulesTTPOSTC(145n)Paclitaxel32445mo23CarboplatinAUCGP(148nGemcitabine30.14.0mo14.8601g/m2,d1,8ddP80NP(145n)Vinorelbine.314.111.44825mg/m2d1,8DDP80IP(145nIrinotecan60mg/m.04.714.2592d18,15DDP80mg/m2,d1目前晚期非小细胞肺癌治疗选择:二线治疗化学治疗■多西他赛(Docetaxel)■培美曲塞(Pemetrexed)靶向治疗■特罗凯(Tarceva)■古非替尼(ressa)DOc二线治疗NSCLCⅢ期临床试验DOC100mg/m21hq3wksRDOC75mg/m21hg3wksTAX320去甲长春花碱30mgm2d1,8,15q3wks,or异环磷酰胺2gm2d1,2,3q3wksDOC100,1hg3wksRDOC75mg/m21hq3wksTAX317最好的支持治疗(SC)ShepherdFJco2000,FossellaCo2000DOC二线治疗NSCLOⅢ期临床试验TAX317TAX320in·14自8---CCC75mgmLogaarkLet,F=00d?654321036912151212210363942454:5157METOPOEEKShep