英语翻译systemic chemotherapy combined with definitive local the

英语翻译
systemic chemotherapy combined with definitive local therapy,is
now the most preferred approach in the battle against stage III
NSCLC.In particular,trimodality therapy,combining surgery,
radiotherapy and chemotherapy,has been intensively investigated
often with promising results.The sequence of ‘trimodality’ therapy
that has most often been employed is induction chemoradiotherapy,
followed by surgical resection,with or without consolidation
chemotherapy.Although such therapy has sometimes been
shown to be highly effective,it is also highly toxic,with a reported
treatment-related death rate of as high as 10%.Careful evaluation
of the risk/benefit ratio of such therapy is thus indispensable.
On the other hand,a small subset of NSCLC called superior
sulcus tumour (SST) or Pancoast’s tumour,in which the tumor
is located in the superior sulcus and involves structures at the
thoracic inlet,has posed a challenging problem for surgeons,
radiation oncologists and medical oncologists alike,ever since it
was first discovered (Rusch et al,2001).However,the trimodality
approach mentioned above has been shown to be associated with a
relatively more favourable risk/benefit ratio in this subset of
patients,for whom it currently appears to be the treatment of first
choice (Rusch et al,2001; Kunitoh et al,2003).
In this study,we review the current data on the use of the
trimodality approach in the treatment of patients with locally
advanced NSCLC,and also discuss means to optimise the
treatment using this approach.
RATIONALES FOR TRIMODALITY THERAPY
Although the strongest rationale for the use of the trimodality
therapy stems from the promising results of clinical phase II data,
upfront systemic chemotherapy offers several practical as well
as theoretical advantages (Pisters et al,2000).Early introduction
of systemic therapy may be expected to lead to early control of
micrometastases.Response to the therapy can be easily assessed by
radiographic imaging,which can help physicians avoid unnecessary,
ineffective therapy.Visualisation of the response could
motivate the patients to accept additional potentially toxic therapy,
which cannot be said for postoperative chemotherapy.In addition,
as compared to the postoperative status,pre-operative patients are
usually in a much fitter state for chemotherapy.
Addition of radiotherapy to preoperative chemotherapy should
mainly be considered for local control (Furuse et al,1999).It has
been observed that at the time of surgery,clinical N2 NSCLCs and
SSTs are often even more advanced in stage than was expected
preoperatively,and the complete resection rates are not sufficiently
satisfactory.With the addition of radiotherapy,a greater
tumour response can be expected,with the hope of better local
control.Hypothetical dissemination of tumour cells during surgery
may also be prevented.

全身化疗相结合,与明确的局部治疗,是现在最可取的办法,在对抗进行第三阶段非小细胞肺癌.特别是,针灸疗法,结合外科手术,放疗和化疗,已在紧锣密鼓地进行调查经常与大有希望的结果.序列' trimodality '疗法这最常被雇用的是诱导化疗,其次是手术切除,或不合并化疗.尽管这种疗法有时被证明非常有效,这也是高毒性,以报治疗相关的死亡率高达10 ％ .仔细评估的风险/效益比这种疗法是不可缺少的.
另一方面,关于一个小的子集非小细胞肺癌中的所谓优势
沟瘤（海温） ,或上沟的肿瘤,其中肿瘤设在上沟,并涉及结构在胸进,构成了一个具有挑战性的问题,为外科医生,放射肿瘤学家和医学肿瘤科均说,该站自第一次被发现（ rusch等人,2001年） .然而,针灸办法上述已证明是与一个相对较为有利的风险/效益比在此子患者为对象,目前看来是治疗的第一选择（ rusch等人,2001年; kunitoh等人,2003年） .
在这项研究中,我们在检讨目前的数据如何使用这个
针灸办法,在治疗局部晚期非小细胞肺癌,并进行了讨论手段来优化治疗用这种办法.
理由：针灸疗法
虽然最强的理由使用该针灸治疗来自可喜的成果,临床第二期的数据,前期全身化疗提供了几种实用以及作为理论优势（ pisters等人,2000年） .早日推出全身治疗可预料将导致早期控制微.响应该疗法可以很容易地进行评估影像,它可以帮助医生避免不必要的,无效治疗.可视化的反应有可能激励患者接受额外的潜在有毒疗法
这不能说是为术后化疗.此外,作为比较,术后状况,手术前病人通常在一个更为钳工国家化疗.
此外,放疗术前化疗应主要是考虑局部控制（古等人,1999年） .它有人指出,在当时的手术,临床氮气nsclcs和ssts往往是更高级阶段,比预期术前,并完全切除率是不够令人满意的.由于增加了放疗的,更大的肿瘤反应,可以预期,并希望更好的地方控制.假设传播的瘤细胞在手术也可能是可以避免的．