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非小细胞肺癌脑转移的管理

The management of brain metastases in non-small cell lung cancer.

作者信息

Owen Scott, Souhami Luis

机构信息

Division of Medical Oncology, Department of Oncology, McGill University Health Centre , Montreal, QC , Canada.

Division of Radiation Oncology, Department of Oncology, McGill University Health Centre , Montreal, QC , Canada.

出版信息

Front Oncol. 2014 Sep 15;4:248. doi: 10.3389/fonc.2014.00248. eCollection 2014.

Abstract

Brain metastases (BM) are a common and lethal complication of non-small cell lung cancer (NSCLC), which portend a poor prognosis. In addition, their management implies several challenges including preservation of neurological and neurocognitive function during surgery or radiation-therapy, minimizing iatrogenic complications of supportive medications, and optimizing drug delivery across the blood-brain barrier. Despite these challenges, advancements in combined modality approaches can deliver hope of improved overall survival and quality of life for a subset of NSCLC patients with BM. Moreover, new drugs harnessing our greater understanding of tumor biology promise to build on this hope. In this mini-review, we revised the management of BM in NSCLC including advancements in neurosurgery, radiation therapy, as well as systemic and supportive therapy.

摘要

脑转移瘤(BM)是非小细胞肺癌(NSCLC)常见且致命的并发症,预示着预后不良。此外,其治疗面临诸多挑战,包括在手术或放疗期间保留神经和神经认知功能、尽量减少支持性药物的医源性并发症,以及优化药物透过血脑屏障的递送。尽管存在这些挑战,但联合治疗方法的进展为一部分患有脑转移瘤的NSCLC患者带来了提高总生存期和生活质量的希望。此外,基于我们对肿瘤生物学更深入的了解而研发的新药有望延续这一希望。在本综述中,我们回顾了NSCLC脑转移瘤的治疗,包括神经外科、放射治疗以及全身和支持治疗方面的进展。

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