McDonald Fiona, Popat Sanjay
The Royal Marsden NHS Foundation Trust, UK.
J Thorac Dis. 2014 Apr;6(4):356-68. doi: 10.3978/j.issn.2072-1439.2013.12.05.
Radical radiotherapy remains the cornerstone of treatment for patients with unresectable locally advanced non small cell lung cancer (NSCLC) either as single modality treatment for poor performance status patients or with sequential or concomitant chemotherapy for good performance status patients. Advances in understanding of tumour molecular biology, targeted drug development and experiences of novel agents in the advanced disease setting have brought targeted agents into the NSCLC clinic. In parallel experience using modified accelerated fractionation schedules in locally advanced disease have demonstrated improved outcomes compared to conventional fractionation in the single modality and sequential chemo-radiotherapy settings. Early studies of targeted agents combined with (chemo-) radiotherapy in locally advanced disease in different clinical settings are discussed below and important areas for future studies are high-lighted.
根治性放疗仍然是无法切除的局部晚期非小细胞肺癌（NSCLC）患者治疗的基石，对于身体状况较差的患者可作为单一治疗方式，对于身体状况较好的患者则可与序贯或同步化疗联合使用。对肿瘤分子生物学理解的进展、靶向药物的开发以及晚期疾病中新型药物的使用经验，已将靶向药物引入NSCLC临床治疗。同时，在局部晚期疾病中使用改良加速分割方案的经验表明，与单一治疗方式及序贯放化疗中的传统分割相比，其疗效有所改善。以下讨论了在不同临床环境下局部晚期疾病中靶向药物联合（化疗）放疗的早期研究，并强调了未来研究的重要领域。
