寡转移非小细胞肺癌的放疗进展

摘要/Abstract

摘要：

对寡转移非小细胞肺癌（NSCLC）进行有效的局部治疗，可延长患者生存期。放疗作为局部治疗手段之一，在NSCLC寡转移患者的治疗中是作为一线治疗还是巩固治疗使用目前尚未定论。多项研究表明立体定向消融放疗可在不增加不良反应的前提下为寡转移NSCLC患者带来临床获益。此外，放疗与免疫治疗联合能否进一步延长寡转移NSCLC患者无进展生存期及总生存期的相关探索也值得关注。

关键词:癌,非小细胞肺,肿瘤转移,放射疗法,计算机辅助

Abstract:

The effective local management of oligometastatic non-small cell lung cancer （NSCLC） has the potential to prolong patients' survival. The role of radiotherapy as a local treatment modality in patients with oligometastatic NSCLC， whether as first-line therapy or consolidation therapy， remains uncertain. Several studies have demonstrated that stereotactic ablative radiotherapy can offer clinical benefits for patients with oligometastatic NSCLC without increasing adverse reactions. Furthermore， the exploration of the potential synergistic effects of combining radiotherapy and immunotherapy on extending progression-free survival and overall survival in patients with oligometastatic NSCLC is also a topic worthy of attention.

Key words:Carcinoma,non-small-cell lung,Neoplasm metastasis,Radiotherapy,computer-assisted

李书月, 马辰莺, 周菊英, 徐晓婷, 秦颂兵. 寡转移非小细胞肺癌的放疗进展[J]. 国际肿瘤学杂志, 2024, 51(3): 170-174.

Li Shuyue, Ma Chenying, Zhou Juying, Xu Xiaoting, Qin Songbing. Progress of radiotherapy in oligometastatic non-small cell lung cancer[J]. Journal of International Oncology, 2024, 51(3): 170-174.

参考文献30

[1]	Han B, Zheng R, Zeng H, et al. Cancer incidence and mortality in China, 2022[J/OL].J Natl Cancer Centdoi. [2024-02-02][2024-02-15]. https://doi.org/10.1016/j.jncc.2024.01.006. DOI:10.1016/j.jncc.2024.01.006.
[2]	Siegel RL, Miller KD, Fuchs HE, et al. Cancer statistics, 2021[J].CA Cancer J Clin,2021,71(1): 7-33. DOI:10.3322/caac.21654.
[3]	Ashworth AB, Senan S, Palma DA, et al. An individual patient data metaanalysis of outcomes and prognostic factors after treatment of oligometastatic non-small-cell lung cancer[J].Clin Lung Cancer,2014,15(5): 346-355. DOI:10.1016/j.cllc.2014.04.003. pmid:24894943
[4]	Iyengar P, All S, Berry MF, et al. Treatment of oligometastatic non-small cell lung cancer: an ASTRO/ESTRO clinical practice guideline[J].Pract Radiat Oncol,2023,13(5): 393-412. DOI:10.1016/j.prro.2023.04.004. pmid:37294262
[5]	Jasper K, Stiles B, McDonald F, et al. Practical management of oligometastatic non-small-cell lung cancer[J].J Clin Oncol,2022,40(6): 635-641. DOI:10.1200/JCO.21.01719. pmid:34985915
[6]	Goldstraw P, Chansky K, Crowley J, et al. The IASLC lung cancer staging project: proposals for revision of the TNM stage groupings in the forthcoming (eighth) edition of the TNM classification for lung cancer[J].J Thorac Oncol,2016,11(1): 39-51. DOI:10.1016/j.jtho.2015.09.009. pmid:26762738
[7]	Dingemans AMC, Hendriks LEL, Berghmans T, et al. Definition of synchronous oligometastatic non-small cell lung cancer—a consensus report[J].J Thorac Oncol,2019,14(12): 2109-2119. DOI:10.1016/j.jtho.2019.07.025.
[8]	Guckenberger M, Lievens Y, Bouma AB, et al. Characterisation and classification of oligometastatic disease: a European Society for Radiotherapy and Oncology and European Organisation for research and treatment of cancer consensus recommendation[J].Lancet Oncol,2020,21(1): e18-e28. DOI:10.1016/S1470-2045(19)30718-1.
[9]	Mack PC, Miao JL, Redman MW, et al. Circulating tumor DNA kinetics predict progression-free and overall survival in EGFR TKI-treated patients with EGFR-mutant NSCLC (SWOG S1403)[J].Clin Cancer Res,2022,28(17): 3752-3760. DOI:10.1158/1078-0432.CCR-22-0741.
[10]	Eslami-S Z, Cortés-Hernández LE, Sinoquet L, et al. Circulating tumour cells and PD-L1-positive small extracellular vesicles: the liquid biopsy combination for prognostic information in patients with metastatic non-small cell lung cancer[J].Br J Cancer,2024,130(1): 63-72. DOI:10.1038/s41416-023-02491-9.
[11]	Schanne DH, Heitmann J, Guckenberger M, et al. Evolution of treatment strategies for oligometastatic NSCLC patients—a syste-matic review of the literature[J].Cancer Treat Rev,2019,80: 101892. DOI:10.1016/j.ctrv.2019.101892.
[12]	Conibear J, Chia B, Ngai Y, et al. Study protocol for the SARON trial: a multicentre, randomised controlled phase Ⅲ trial compa-ring the addition of stereotactic ablative radiotherapy and radical radiotherapy with standard chemotherapy alone for oligometastatic non-small cell lung cancer[J].BMJ Open,2018,8(4): e020690. DOI:10.1136/bmjopen-2017-020690.
[13]	Blake-Cerda M, Lozano-Ruíz F, Maldonado-Magos F, et al. Consolidative stereotactic ablative radiotherapy (SABR) to intrapulmonary lesions is associated with prolonged progression-free survival and overall survival in oligometastatic NSCLC patients: a prospective phase 2 study[J].Lung Cancer,2021,152: 119-126. DOI:10.1016/j.lungcan.2020.12.029. pmid:33385737
[14]	马辰莺, 徐晓婷, 秦颂兵, 等. 早期放疗干预对非小细胞肺癌寡转移患者的有效性及安全性分析[J].中华放射医学与防护杂志,2021,41(10): 726-734. DOI:10.3760/cma.j.issn.0254-5098.2021.10.002.
[15]	Arrieta O, Barrón F, Maldonado F, et al. Radical consolidative treatment provides a clinical benefit and long-term survival in patients with synchronous oligometastatic non-small cell lung cancer: a phase Ⅱ study[J].Lung Cancer,2019,130: 67-75. DOI:10.1016/j.lungcan.2019.02.006. pmid:30885354
[16]	Gondi V, Bauman G, Bradfield L, et al. Radiation therapy for brain metastases: an ASTRO clinical practice guideline[J].Pract Radiat Oncol,2022,12(4): 265-282. DOI:10.1016/j.prro.2022.02.003. pmid:35534352
[17]	Iyengar P, Wardak Z, Gerber DE, et al. Consolidative radiotherapy for limited metastatic non-small-cell lung cancer: a phase 2 randomized clinical trial[J].JAMA Oncole1,2017,4(1): e173501. DOI:10.1001/jamaoncol.2017.3501.
[18]	Kao J, Farrugia MK, Frontario S, et al. Association of radiation dose intensity with overall survival in patients with distant metastases[J].Cancer Med,2021,10(22): 7934-7942. DOI:10.1002/cam4.4304.
[19]	Ramroth J, Cutter DJ, Darby SC, et al. Dose and fractionation in radiation therapy of curative intent for non-small cell lung cancer: meta-analysis of randomized trials[J].Int J Radiat Oncol Biol Phys,2016,96(4): 736-747. DOI:10.1016/j.ijrobp.2016.07.022.
[20]	Benson KRK, Aggarwal S, Carter JN, et al. Predicting survival for patients with metastatic disease[J].Int J Radiat Oncol Biol Phys,2020,106(1): 52-60. DOI:10.1016/j.ijrobp.2019.10.032.
[21]	Nguyen QN, Chun SG, Chow E, et al. Single-fraction stereotactic vs conventional multifraction radiotherapy for pain relief in patients with predominantly nonspine bone metastases: a randomized phase 2 trial[J].JAMA Oncol,2019,5(6): 872-878. DOI:10.1001/jamaoncol.2019.0192.
[22]	Hong JC, Ayala-Peacock DN, Lee J, et al. Classification for long-term survival in oligometastatic patients treated with ablative radiotherapy: a multi-institutional pooled analysis[J].PLoS One,2018,13(4): e0195149. DOI:10.1371/journal.pone.0195149.
[23]	Lehrer EJ, Singh R, Wang M, et al. Safety and survival rates associated with ablative stereotactic radiotherapy for patients with oligometastatic cancer: a systematic review and meta-analysis[J].JAMA Oncol,2021,7(1): 92-106. DOI:10.1001/jamaoncol.2020.6146. pmid:33237270
[24]	Garde-Noguera J, Martín-Martín M, Obeso A, et al. Current treatment landscape for oligometastatic non-small cell lung cancer[J].World J Clin Oncol,2022,13(6): 485-495. DOI:10.5306/wjco.v13.i6.485. pmid:35949432
[25]	Gomez DR, Tang C, Zhang JJ, et al. Local consolidative therapy vs. maintenance therapy or observation for patients with oligometastatic non-small-cell lung cancer: long-term results of a multi-institutional, phase Ⅱ, randomized study[J].J Clin Oncol,2019,37(18): 1558-1565. DOI:10.1200/JCO.19.00201.
[26]	Palma DA, Olson R, Harrow S, et al. Stereotactic ablative radiotherapy versus standard of care palliative treatment in patients with oligometastatic cancers (SABR-COMET): a randomised, phase 2, open-label trial[J].Lancet,2019,393(10185): 2051-2058. DOI:10.1016/S0140-6736(18)32487-5. pmid:30982687
[27]	Van den Begin R, Engels B, Collen C, et al. The METABANK score: a clinical tool to predict survival after stereotactic radiotherapy for oligometastatic disease[J].Radiother Oncol,2019,133: 113-119. DOI:10.1016/j.radonc.2019.01.001. pmid:30935566
[28]	Tomasini P, Greillier L, Boyer A, et al. Durvalumab after chemoradiotherapy in stage Ⅲ non-small cell lung cancer[J].J Thorac Dis,2018,10(Suppl 9): S1032-S1036. DOI:10.21037/jtd.2018.04.61.
[29]	Bauml JM, Mick R, Ciunci C, et al. Pembrolizumab after completion of locally ablative therapy for oligometastatic non-small cell lung cancer: a phase 2 trial[J].JAMA Oncol,2019,5(9): 1283-1290. DOI:10.1001/jamaoncol.2019.1449.
[30]	Bestvina CM, Pointer KB, Karrison T, et al. A phas 1 trial of concurrent or sequential ipilimumab, nivolumab, and stereotactic body radiotherapy in patients with stage Ⅳ NSCLC study[J].J Thorac Oncol,2022,17(1): 130-140. DOI:10.1016/j.jtho.2021.08.019.