Nishino Mizuki, Hatabu Hiroto, Sholl Lynette M, Ramaiya Nikhil H
From the Departments of Radiology (M.N., H.H., N.H.R.) and Pathology (L.M.S.), Brigham and Women's Hospital and Dana-Farber Cancer Institute, 450 Brookline Ave, Boston, MA 02215.
Radiographics. 2017 Sep-Oct;37(5):1371-1387. doi: 10.1148/rg.2017170015.
Recent advances in understanding the molecular mechanisms of cancer have opened a new era of precision medicine for cancer treatment. Precision cancer therapies target specific molecules that are responsible for cancer development and progression, and they achieve marked treatment benefits in specific cohorts of patients. However, these therapies are also associated with a variety of complications that are often unique to specific groups of anticancer agents. The rapidly increasing use of immune checkpoint inhibitors in the treatment of various advanced malignancies has brought new challenges in diagnosing and monitoring a unique set of toxic effects termed immune-related adverse events. Familiarity with cutting-edge cancer treatment approaches and awareness of the emerging complications from novel therapies are essential for radiologists, who play a key role in the care of patients with cancer. This article provides a comprehensive review of the thoracic complications of precision cancer therapies, describes their imaging features and clinical characteristics, and discusses the role of radiologists in the diagnosis and monitoring of these entities. The authors also address the molecular mechanisms of anticancer agents that relate to thoracic complications and emphasize emerging challenges in novel cancer therapies. This article is designed to serve as a practical reference guide for day-to-day practice for radiologists in the era of precision cancer medicine. RSNA, 2017.
在理解癌症分子机制方面的最新进展开启了癌症治疗精准医学的新时代。精准癌症疗法靶向负责癌症发生和进展的特定分子,并在特定患者群体中取得显著的治疗效果。然而,这些疗法也伴随着各种并发症,这些并发症往往是特定抗癌药物组所特有的。免疫检查点抑制剂在各种晚期恶性肿瘤治疗中的迅速增加使用,给诊断和监测一组独特的毒性效应(称为免疫相关不良事件)带来了新的挑战。熟悉前沿癌症治疗方法并了解新型疗法出现的并发症,对于在癌症患者护理中发挥关键作用的放射科医生来说至关重要。本文全面综述了精准癌症疗法的胸部并发症,描述了它们的影像学特征和临床特点,并讨论了放射科医生在这些实体的诊断和监测中的作用。作者还阐述了与胸部并发症相关的抗癌药物分子机制,并强调了新型癌症疗法中出现的挑战。本文旨在作为精准癌症医学时代放射科医生日常实践的实用参考指南。RSNA,2017年。