是否所有肺癌患者术后都需要进行辅助化疗？

肺癌是全身疾病的概念已经被大家所接受，肺癌治疗模式已经转变为多学科综合治疗，包括外科手术、放疗、化疗、免疫治疗以及中医中药等。肺癌手术后进行4-6个周期的辅助化疗已经在全国许多肺癌中心开展。那么，是否所有肺癌患者手术切除后都需要进行化疗和/或放疗吗？

答案是否定的。

如果肺癌病灶直径小于3厘米、并且没有外侵，没有肺门和纵隔淋巴结转移，我们称之为“早期肺癌”，医学专业术语为“Ia期”肺癌。临床试验证明对Ia期非小细胞肺癌患者手术后进行化疗不但不能延长寿命，反而因化疗的毒副作用使存活期缩短。因此，Ia期肺癌患者手术后不需要进行辅助化疗。

另外对于年龄在75岁以上的老年肺癌患者手术后进行辅助化疗同样不能取得生存率的提高。因为老年患者身体各方面的机能均有不同程度的减退，不容易从化疗导致的骨髓抑制、胃肠道反应中恢复。

Adjuvant therapy is treatment that is given after surgery to lower the risk of the lung cancer returning. Adjuvant therapies include radiation therapy, chemotherapy, and targeted therapies. They are intended to eliminate any lung cancer cells that may be lingering in the body. Adjuvant therapy may decrease the risk of recurrence, but does not necessarily eliminate it.

Along with staging, other sophisticated tools can help determine prognosis and help you and your doctor make decisions about whether adjuvant therapy would be helpful in your treatment. The website Adjuvant! (www.adjuvantonline.com) is one such tool that your doctor can access to interpret a variety of factors that are important for making the treatment decision. This website should only be used in consultation with your doctor who best knows you and your medical condition.

For additional information, read the ASCO Patient Guide: Adjuvant Treatment for Lung Cancer.