化疗方案缩写搞不清?一文盘点肺癌、乳腺癌、结直肠癌、胃癌经典化疗方案

2022-04-06 肿瘤新前沿 MedSci原创

化疗方案大盘点!

一、肺癌

无驱动基因突变的非小细胞肺癌(NSCLC)患者,化疗仍是抗肿瘤治疗的基石。含铂两药化疗方案为非小细胞肺癌最常用的化疗方案。

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NSCLC经典一线方案为含铂两药。对于不能耐受铂化疗的患者,可选非铂两药方案。

对于肺腺癌,通常选培美曲塞+顺铂。对肺鳞癌,可以选择紫杉醇+顺铂/卡铂,或者吉西他滨+顺铂/卡铂等。

同样联合铂类,紫杉醇脂质体与紫杉醇相比,疗效相当,有更优的安全性和耐受性,末梢神经炎更加低。

对于一线治疗4-6周期后,疾病无进展、体力状态佳、不良反应能耐受的患者,可考虑单药维持治疗。

PS评分0-2的给予二线化疗,在二线治疗中,两药方案较单药未显示出生存获益。肺腺癌一般优先选择选培美曲塞和多西他赛。肺鳞癌一般优先选择多西他赛和吉西他滨,也可长春瑞滨。

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依托泊苷联合顺铂或卡铂是一线治疗的标准方案。此外,伊立替康联合铂类方案也是一线治疗的可选择方案。对于不适用顺铂的患者,也可以选择依托泊苷联合洛铂方案。

  • 对于一线治疗后超过6个月复发的SCLC,一线治疗比较敏感的患者,可再次使用原一线方案。

  • 对于复发时间小于6个月的患者,二线考虑换药;单药包括:托泊替康、伊立替康、吉西他滨、紫杉醇、多西他赛、替莫唑胺等。

二、乳腺癌

  • 对于肿瘤负荷、无明显症状的晚期乳腺癌患者可优先考虑单药化疗;

  • 对于有症状的或需要快速缓解的内脏转移,优先选择联合化疗。选择联合化疗时需要权衡疗效与不良反应。

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三、结直肠癌

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四、胃癌

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    2022-08-17 jackeyxu1975

    学习了

    0

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    2022-04-09 jing0309

    好文,收藏了

    0

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