Goto Yasushi, Sato Jun
Dept. of Thoracic Oncology, National Cancer Center Hospital.
Gan To Kagaku Ryoho. 2017 Oct;44(10):817-820.
Lung cancer with a few to several metastases is so-called oligometastatic disease. Patient with recurrence only to limited site is also known as oligo-recurrence, and may be included as oligometastatic disease. From biological aspect, any existence of metastases is a sign of systemic disease. Due to the reports of long survival with only local treatment and without systemic disease in oligometastatic lung cancer, word of oligometastasis is used with fascinating expectation of cure to advanced lung cancer. Most of the previous reports are retrospective and no comprehensive data exists for selecting patient for local treatment to oligometastasis. Recent positive result of randomize phase II study is followed up with phase III study. Progress in treatment of advanced non-small cell lung cancer with targeted therapy to oncogenic-driver(EGFR, ALK, ROS1 and others) and immune-checkpoint inhibitor(PD-1 pathway inhibitors)makes it difficult to define the appropriate indication of local treatment to oligometastatic lung cancer.
伴有少数至多个转移灶的肺癌被称为寡转移疾病。仅在有限部位复发的患者也被称为寡复发，可能被纳入寡转移疾病范畴。从生物学角度来看，任何转移灶的存在都是全身性疾病的标志。由于有报道称寡转移肺癌患者仅接受局部治疗且无全身性疾病时生存期较长，“寡转移”一词被用于对晚期肺癌治愈的美好期望之中。此前的大多数报道都是回顾性的，目前尚无用于选择接受寡转移局部治疗患者的全面数据。近期随机II期研究的阳性结果之后紧接着进行III期研究。针对致癌驱动因子（表皮生长因子受体、间变性淋巴瘤激酶、ROS1等）的靶向治疗以及免疫检查点抑制剂（程序性死亡受体1通路抑制剂）在晚期非小细胞肺癌治疗方面取得的进展，使得难以界定寡转移肺癌局部治疗的合适适应症。
