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首页 肺癌化疗方案

肺癌化疗方案.doc

肺癌化疗方案

心腐烂在身体
2018-11-24 0人阅读 举报 0 0 0 暂无简介

简介:本文档为《肺癌化疗方案doc》,可适用于医药卫生领域

肺癌化疗方案非小细胞肺癌化疗原则:·尽管同时化疗和放疗,但是数据支持全剂量的顺铂方案优于含卡珀方案卡铂方案没有充分测试。·治疗晚期病人原则:含铂类化疗方案延长了生存率,提高了症状控制率,与最好支持性护理可得到更好的生活质量。没有具体含铂化疗方案的细胞毒性明显优于另一组化疗方案。患者年龄的病人生活质量评分或,都不能从细胞毒性化疗中获益,而由表皮生长受体(EGFR)突变阳性病人接受(erlotinib)埃罗替尼能获益。非小细胞肺癌辅助性化疗Cisplatin(PlatinolCDDP)vinorelbine(Navelbine)–Daysand:CisplatinmgmIV,plusDays,,and:VinorelbinemgmIVRepeatcycleeveryweeksforcycles或者Day:CisplatinmgmIV,plusDays,,and:VinorelbinemgmIVRepeatcycleeveryweeksforcyclesCisplatinetoposide(Toposar,VePesid,EtopophosVP),Day:CisplatinmgmIV,plusDays–:EtoposidemgmIVRepeatcycleeveryweeksforcyclesCisplatinvinblastine(Velban),Days:CisplatinmgmIVRepeatcycleeveryweeksforcyclesDays,,and:VinblastinemgmIV,theneveryweeksafterDayuntillastcisplatinadministrationCisplatingemcitabine(Gemzar)Day:CisplatinmgmIV,plusDaysand:Gemcitabine,mgmIVRepeatcycleeveryweeksCisplatindocetaxel(Taxotere),Day:DocetaxelmgmIVcisplatinmgmIVRepeatcycleeveryweeksCisplatinpemetrexed(Alimta)Day:CisplatinmgmIVpemetrexedmgmIVRepeatcycleeveryweeksforcycles(ForadenocarcinomaandlargecellcarcinomaandNSCLCNOSwithoutspecifichistologicsubtype)Paclitaxel(Taxol)carboplatin(Paraplatin),Day:PaclitaxelmgmIVcarboplatinAUC=mgmLminIVRepeatcycleeveryweeksforcycles同时化放疗方案Cisplatinetoposide,Days,,and:CisplatinmgmIV,plusDays–and–:EtoposidemgmIV,plusConcurrentthoracicRTGydayfordaysweek(totaldose,Gy)preferredregimenCisplatinvinblastine,Daysand:CisplatinmgmIV,plusDays,,,and:VinblastinemgmIVConcurrentthoracicRT(totaldose,Gy)preferredregimen序惯化放疗Cisplatinvinblastine,Daysand:CisplatinmgmIVDays,,,and:VinblastinemgmIVfollowedbyRTwithGyinfractionsbeginningonDayPaclitaxelcarboplatin,Day:PaclitaxelmgmIVcarboplatinAUC=mgmLminIVRepeatcycleeveryweekscycles,followedbythoracicRTGybeginningonDay晚期肺癌线化疗方案Bevacizumab(Avastin)carboplatinandpaclitaxel,,Day:PaclitaxelmgmIVDay:CarboplatinAUCIVRepeateveryweeksforcyclesDay:BevacizumabmgkgIVeveryweeksuntildiseaseprogressionCetuximab(Erbitux)cisplatinandvinorelbine,Day:CetuximabmgmIVcisplatinmgmIV,plusDaysand:VinorelbinemgmIV,plusDay:CetuximabmgmIVonceweeklyRepeatcycleeveryweeksforcyclesIndicatedinadvancedNSCLCErlotinib(Tarceva),,Day:ErlotinibmgorallyoncedailyfollowingcyclesofplatinumbasedchemotherapyIndicatedforEGFRmutationpositivepatientsandmaybeconsideredasanoptionforpatientswhotestpositiveforanEGFRmutationCisplatinpaclitaxel,Day:PaclitaxelmgmIVoverhrsDay:CisplatinmgmIVRepeateveryweeksCisplatingemcitabine,Day:CisplatinmgmIVDays,and:Gemcitabine,mgmIVRepeateveryweeksCisplatindocetaxel,Day:CisplatinmgmIVDay:DocetaxelmgmIVRepeateveryweeksCisplatinvinorelbine,Day:CisplatinmgmIVDays,,and:VinorelbinemgmIVoverminRepeateveryweeksCarboplatinpaclitaxel,Day:CarboplatinAUCIVDay:PaclitaxelmgmIVoverhoursRepeateveryweeksPemetrexed(Alimta)cisplatin,,Day:PemetrexedmgmIVcisplatinmgmIVRepeatcycleeveryweeksCrizotinib(Xalkori),CrizotinibmgorallytwicedailyMayreducetomgtwicedailynottoleratedortoxicityoccursIffurtherreductionisneeded,reducetomgoncedailyIndicatedforALKpositivepatients晚期肺癌II线化疗方案DocetaxelorPemetrexedorErlotinib,–*Inpatientswhohaveexperienceddiseaseprogressioneitherduringorafterfirstlinetherapy,singleagentdocetaxel,pemetrexed,orerlotinibareestablishedsecondlineagentsDay:DocetaxelmgmIVRepeatcycleeveryweeksDocetaxelhasprovedsuperiortoBSC,vinorelbine,orifosfamidewithimprovedsurvivalandqualityoflife或者Day:PemetrexedmgmIVRepeatcycleeveryweeksPemetrexedhasbeenshowntobesuperiortodocetaxelwithlesstoxicityinpatientswithadenocarcinomaandlargecellcarcinoma(nonsquamoushistology)或者Day:ErlotinibmgorallyoncedailyErlotinibhasprovedsuperiortoBSCwithsignificantlyimprovedsurvivalanddelayedtimetosymptomdeteriorationinNSCLCpatientspreviouslytreatedwithchemotherapy晚期肺癌III线化疗方案Erlotinib,Day:ErlotinibmgorallyoncedailyErlotinibhasprovedsuperiortoBSCwithsignificantlyimprovedsurvivalanddelayedtimetosymptomdeteriorationinpatientswhopreviouslyfailedfirstandsecondlinechemotherapy小细胞肺癌化疗原则·在化疗加放疗中选择cisplatinetoposide·二线或者复发病人选择临床试验局限性病变Cisplatinetoposide,,NOTE:CategoryDay:CisplatinmgmIV,plusDays–:EtoposidemgmIVRepeatcycleeveryweeksforatleastcyclesRadiotherapyGyoncedailyto–GyorGytwicedailytoGyCisplatinetoposide,NOTE:CategoryDay:CisplatinmgmIV,plusDays–:EtoposidemgmIVRepeateveryweeksfor–cyclesCarboplatinetoposide,Day:CarboplatinAUC–IV,plusDays–:EtoposidemgmIVRepeatcycleeveryweeksfor–cycles广泛性病变Cisplatinetoposide,Day:CisplatinmgmIVDays–:EtoposidemgmIVRepeateveryweeksfor–cyclesCisplatinetoposide,Days:CisplatinmgmIVDays–:EtoposidemgmIVRepeateveryweeksfor–cyclesCisplatinetoposide,Days–:CisplatinmgmIVetoposidemgmFor–cyclesCisplatinirinotecan,,,Day:CisplatinmgmIVDays,and:IrinotecanmgmIVRepeatcycleeveryweeksforcycles或者Dayand:CisplatinmgmIVDayand:IrinotecanmgmIVRepeateveryweeksfor–cyclesCarboplatinirinotecan,Day:CarboplatinAUC=mgmLminIV,plusDays,and:IrinotecanmgmIVRepeatcycleeveryweeksfor–cyclesCarboplatinEtoposide,Day:CarboplatinAUC–Days–:EtoposidemgmIVRepeateveryweeksfor–cycles

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