Department of Radiation Oncology, London Health Sciences Centre, London, Ontario, Canada.
Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York.
Semin Respir Crit Care Med. 2020 Jun;41(3):369-376. doi: 10.1055/s-0039-3400290. Epub 2020 May 25.
The oligometastatic and oligoprogressive disease states have been recently recognized as common clinical scenarios in the management of non-small cell lung cancer (NSCLC). As a result, there has been increasing interest in treating these patients with locally ablative therapies including surgery, conventionally fractionated radiotherapy, stereotactic ablative radiotherapy, and radiofrequency ablation. This article provides an overview of oligometastatic and oligoprogressive disease in the setting of NSCLC and reviews the evidence supporting ablative treatment. Phase II randomized controlled trials and retrospective series suggest that ablative treatment of oligometastases may substantially improve progression-free survival and overall survival, and additional large randomized studies testing this hypothesis in a definitive context are ongoing. However, several challenges remain, including quantifying the possible benefits of ablative therapies for oligoprogressive disease and developing prognostic and predictive models to assist in clinical decision making.
寡转移和寡进展疾病状态最近被认为是非小细胞肺癌 (NSCLC) 治疗中的常见临床情况。因此，人们越来越感兴趣地用局部消融疗法治疗这些患者，包括手术、常规分割放疗、立体定向消融放疗和射频消融。本文概述了 NSCLC 中寡转移和寡进展疾病，并回顾了支持消融治疗的证据。Ⅱ期随机对照试验和回顾性系列研究表明，寡转移的消融治疗可能显著改善无进展生存期和总生存期，正在进行更大规模的随机研究以明确验证该假说。然而，仍存在一些挑战，包括量化消融治疗对寡进展疾病的可能益处，以及开发预测和预后模型以协助临床决策。
