Billing David L, Rimner Andreas
Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA.
Cancers (Basel). 2021 Nov 18;13(22):5773. doi: 10.3390/cancers13225773.
Oligometastatic cancer is characterized by a limited number of metastatic deposits. Compared with lung cancer patients who have more widespread disease, oligometastatic lung cancer patients have more favorable survival outcomes. Therefore, it has been hypothesized that local ablative therapy (LAT) directed at the metastatic deposits in addition to standard-of-care systemic therapy may further improve survival outcomes in oligometastatic lung cancer patients. One LAT modality that has been utilized in oligometastatic lung cancer is radiation therapy. In particular, ultra-hypofractionated radiotherapy, also known as stereotactic body radiotherapy (SBRT), has been shown to provide excellent local control with a favorable safety profile. Here, we reviewed the retrospective studies and prospective trials that have deployed radiation therapy as LAT in oligometastatic lung cancer, including randomized studies showing benefits for progression-free survival and overall survival with the addition of LAT. We also discuss the impact of targeted therapies and immunotherapy on radiation as LAT.
寡转移癌的特征是转移灶数量有限。与患有更广泛疾病的肺癌患者相比,寡转移肺癌患者的生存结果更有利。因此,有人提出,除了标准的全身治疗外,针对转移灶的局部消融治疗(LAT)可能会进一步改善寡转移肺癌患者的生存结果。在寡转移肺癌中使用的一种LAT方式是放射治疗。特别是,超分割放疗,也称为立体定向体部放疗(SBRT),已被证明能提供良好的局部控制,且安全性良好。在此,我们回顾了将放射治疗作为寡转移肺癌LAT的回顾性研究和前瞻性试验,包括显示添加LAT可使无进展生存期和总生存期受益的随机研究。我们还讨论了靶向治疗和免疫治疗对作为LAT的放射治疗的影响。