Roy Simon F, Louie Alexander V, Liberman Moishe, Wong Philip, Bahig Houda
Department of Pathology, University of Montreal, Montreal, QC, Canada.
Department of Radiation Oncology, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
Transl Lung Cancer Res. 2019 Sep;8(Suppl 2):S124-S134. doi: 10.21037/tlcr.2019.09.05.
In non-small cell lung cancer (NSCLC), pathologic complete response (pCR) following radiotherapy treatment has been shown to be an independent prognostic factor for long-term survival, progression-free survival and locoregional control. PCR is considered a surrogate to therapeutic efficacy, years before survival data are available, and therefore can be used to guide treatment plans and additional therapeutic interventions post-surgical resection. Given the extensive fibrotic changes induced by radiotherapy in the lung, radiological assessment of response can potentially misrepresent pathologic response. The optimal timing for assessment of pathologic response after conventionally fractionated radiotherapy and stereotactic ablative radiotherapy (SABR) remains poorly understood. In this review, we summarize recent literature on pathologic response after radiotherapy for early stage and locally advanced NSCLC, we discuss current controversies around radiobiological considerations, and we present upcoming trials that will provide insight into current knowledge gaps.
在非小细胞肺癌（NSCLC）中，放疗后的病理完全缓解（pCR）已被证明是长期生存、无进展生存和局部区域控制的独立预后因素。在生存数据可得前数年，PCR就被视为治疗效果的替代指标，因此可用于指导手术切除后的治疗计划和额外的治疗干预。鉴于放疗在肺部引起的广泛纤维化改变，反应的放射学评估可能会错误呈现病理反应。对于常规分割放疗和立体定向消融放疗（SABR）后病理反应的评估，最佳时机仍知之甚少。在本综述中，我们总结了早期和局部晚期NSCLC放疗后病理反应的最新文献，讨论了围绕放射生物学考量的当前争议，并介绍了即将开展的试验，这些试验将深入了解当前的知识空白。
