Division of Respiratory Medicine and Thoracic Oncology, Dept of Medicine, University of Munich - Campus Innenstadt, Comprehensive Pneumology Center Munich (CPC-M) and Thoracic Oncology Centre Munich, Munich, Germany
Member of the German Centre of Lung Research.
Eur Respir Rev. 2021 May 5;30(160). doi: 10.1183/16000617.0227-2020. Print 2021 Jun 30.
Locally advanced nonsmall cell lung cancer, due to its varying prognosis, is grouped according to TNM stage IIIA, IIIB and IIIC. Developments over the last 3 years have been focused on the integration of immunotherapy into the combination treatment of a locally definitive therapy (surgery or radiotherapy) and chemotherapy. For concurrent chemoradiotherapy, consolidation therapy with durvalumab was established. Adjuvant targeted therapy has again gained increasing interest. In order to adapt treatment to the specific stage subgroup and its prognosis, fluorodeoxyglucose positron emission tomography/computed tomography and pathological evaluation of the mediastinum are important. Tumours should be investigated for immunological features and driver mutations. Regarding toxicity, evaluation of pulmonary and cardiac function, as well as symptoms and quality of life, is of increasing importance. To improve the management and prognosis of this heterogeneous entity, clinical trials and registries should take these factors into account.
局部晚期非小细胞肺癌因其预后不同，根据 TNM 分期分为 IIIA、IIIB 和 IIIC。过去 3 年来，研究重点一直集中在将免疫疗法纳入局部确定性治疗（手术或放疗）和化疗的联合治疗中。对于同期放化疗，采用度伐利尤单抗进行巩固治疗。辅助靶向治疗再次引起了越来越多的关注。为了使治疗适应特定的分期亚组及其预后，氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描和纵隔的病理评估非常重要。应研究肿瘤的免疫特征和驱动突变。关于毒性，肺和心脏功能以及症状和生活质量的评估变得越来越重要。为了改善这种异质实体的管理和预后，临床试验和登记处应考虑这些因素。
