Advanced Radiation Oncology Department, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, Italy.
Dipartimento di Radioterapia Oncologica, Università e ASST Spedali Civili di Brescia, Brescia, Italy.
Expert Rev Anticancer Ther. 2020 May;20(5):387-402. doi: 10.1080/14737140.2020.1760094. Epub 2020 May 13.
: Radiotherapy is an important therapeutic strategy in the management of non-small cell lung cancer (NSCLC). In recent decades, technological implementations and the introduction of image guided radiotherapy (IGRT) have significantly increased the accuracy and tolerability of radiation therapy.: In this review, we provide an overview of technological opportunities and future prospects in NSCLC management.: Stereotactic body radiotherapy (SBRT) is now considered the standard approach in patients ineligible for surgery, while in operable cases, it is still under debate. Additionally, in combination with systemic treatment, SBRT is an innovative option for managing oligometastatic patients and features encouraging initial results in clinical outcomes. To date, in inoperable locally advanced NSCLC, the radical dose prescription has not changed (60 Gy in 30 fractions), despite the median overall survival progressively increasing. These results arise from technological improvements in precisely hitting target treatment volumes and organ at risk sparing, which are associated with better treatment qualities. Finally, for the management of NSCLC, proton and carbon ion therapies and the recent development of MR-Linac are new, intriguing technological approaches under investigation.
放射治疗是非小细胞肺癌(NSCLC)治疗的重要策略。近几十年来,技术的应用和图像引导放射治疗(IGRT)的引入显著提高了放射治疗的准确性和耐受性。在本文综述中,我们概述了 NSCLC 管理中的技术机会和未来前景。立体定向体部放射治疗(SBRT)现在被认为是不符合手术条件患者的标准治疗方法,而对于可手术的病例,其仍然存在争议。此外,SBRT 与系统治疗相结合是治疗寡转移患者的一种创新选择,其在临床结果方面具有令人鼓舞的初步结果。迄今为止,在不可手术的局部晚期 NSCLC 中,尽管中位总生存期逐渐延长,但根治性剂量仍保持不变(60 Gy/30 次)。这些结果源于精确打击靶区和保护危险器官的技术改进,这与更好的治疗质量有关。最后,对于 NSCLC 的治疗,质子和碳离子治疗以及最近开发的磁共振引导直线加速器是正在研究的新的、有趣的技术方法。