Mason Joel, Blyth Benjamin, MacManus Michael P, Martin Olga A
Division of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia.
Research Division, Peter MacCallum Cancer Center, Melbourne, Australia.
Lung Cancer Manag. 2017 Dec;6(4):129-139. doi: 10.2217/lmt-2017-0019. Epub 2018 Jun 22.
Surgery is the main curative therapy for patients with localized non-small-cell lung cancer while radiotherapy (RT), alone or with concurrent platinum-based chemotherapy, remains the primary curative modality for locoregionally advanced non-small-cell lung cancer. The risk of distant metastasis is high after curative-intent treatment, largely attributable to the presence of undetected micrometastases, but which could also be related to treatment-related increases in circulating tumor cells (CTCs). CTC mobilization by RT or systemic therapies might either reflect efficient tumor destruction with improved prognosis, or might promote metastasis and thus represent a potential therapeutic target. RT may induce prometastatic biological alterations in CTC at the cellular level, which are detectable by 'liquid biopsies', though their rarity represents a major challenge. Improved methods of isolation and propagation will be essential for the future of CTC research.
手术是局限性非小细胞肺癌患者的主要治疗方法，而放疗（RT），单独使用或与铂类化疗联合使用，仍然是局部晚期非小细胞肺癌的主要治疗方式。根治性治疗后远处转移的风险很高，这在很大程度上归因于未检测到的微转移灶的存在，但也可能与治疗相关的循环肿瘤细胞（CTC）增加有关。放疗或全身治疗引起的CTC动员可能反映了有效的肿瘤破坏且预后改善，也可能促进转移，因此是一个潜在的治疗靶点。放疗可能在细胞水平上诱导CTC发生促转移的生物学改变，这可以通过“液体活检”检测到，尽管它们的罕见性是一个重大挑战。改进的分离和增殖方法对于CTC研究的未来至关重要。
