1、 肺癌化疗的规范性治疗肺 癌 发病率在大多数国家明显 ,发达国家男性恶性肿瘤首位,女性为第2、3位。 我国近30年发病率亦明显 ,尤其在大城市和工矿区,在城市占男性恶性肿瘤死亡38.08%、女性16.16%,均居首位。 从我国分布来看,上海、北京、东北和沿海几个大城市死亡率最高,云南有二个高发区宣威和个旧。中国肺癌流行病学回顾261,839119,648381,487332,286165,622497,9080100,000200,000300,000400,000500,000600,000男 女 总2000 200526.9%38.4%30.5%2000-2005年肺癌患者数Yang et
2、 al, 2005患者数中国肺癌流行病学回顾2000-2005年肺癌发病率43.019.149.022.90.010.020.030.040.050.060.0男 (ASR*) 女 (ASR*)2000 200514.0%19.9%Per 100,000Yang et al, 2005* ASR: Age-standardized incidence rate (per 100,000) using world standard population中国肺癌流行病学回顾2000-2005年癌症发病率排名Rank Male (ASR*) 2000 Rank Male (ASR*) 20051 L
3、ung 43.0 1 Lung 49.02 Stomach 41.9 2 Liver 40.03 Liver 38.9 3 Stomach 37.14 Esophagus 27.6 4 Esophagus 24.05 Colon/rectum 14.0 5 Colon/rectum 15.0Yang et al, 2005Rank Female (ASR*) 2000 Rank Female (ASR*) 20051 Breast 19.9 1 Breast 24.82 Stomach 19.5 2 Lung 22.93 Lung 19.2 3 Stomach 17.44 Liver 14.5
4、 4 Liver 15.35 Esophagus 12.1 5 Esophagus 9.7* ASR: Age-standardized incidence rate (per 100,000) using world standard population中国肺癌流行病学回顾 Cumulative Risk: (up to 74 years of age) were calculated to give the net risk (as a percentage) which an individual would have of developing the cancer in quest
5、ion before the age of 75 in the absence of other causes of death肺癌成为累积危险性最高的癌症Male Cumulative Risk 2000 Male Cumulative Risk 20051 Lung 5.1 1 Lung 5.72 Stomach 4.9 2 Liver 4.33 Liver 4.2 2 Stomach 4.34 Esophagus 3.3 4 Esophagus 2.95 Colon/rectum 1.6 5 Colon/rectum 1.7Female Cumulative Risk 2000 Fema
6、le Cumulative Risk 20051 Stomach 2.3 1 Lung 2.62 Lung 2.2 2 Breast 2.33 Breast 1.9 3 Stomach 2.04 Liver 1.6 4 Liver 1.75 Esophagus 1.4 5 Esophagus 1.2 Yang et al, 2005Females Males8060402001930 1940 1950 1960 1970 1980 1990 19978060402001930 1940 1950 1960 1970 1980 1990 1997UterusBreastPancreasOvar
7、yStomachLung and bronchusColon and rectumPancreasLiverProstateStomachLung and bronchus Colon and rectumLeukemiaRate per 100,000Rate per 100,000Year YearCANCER MORTALITY RATES: USA 2002 Age-Adjusted Cancer Death Rates,* for Females by Site, US, 1930-1997Age-Adjusted Cancer Death Rates,* for Males by Site, US, 1930-1997肺 癌 NSCLC 80%,腺/鳞癌比例 ,III/IV期 65% 占恶性肿瘤死亡人数1/3 死亡人数较乳腺癌、前列腺癌和结肠癌的总和还多 80%-90%的肺癌病人最终死于肺癌小 细 胞 肺 癌小细胞肺癌(SCLC) SCLC约占肺癌20-25%通常与吸烟有关。 生物学特性恶性程度高,确诊时大多为III/IV期,胜床上分局限期和广泛期,仅少数周围型早期患者 治疗。 局限期首 化、 疗 治疗, 者 性的 。广泛期首 化疗, 者 性 疗。