Wang Mingyue, Li Shuo, Li Runyu, Ning Fangling, Tian Lijun
The Department of Oncology, Binzhou Medical University Hospital, Binzhou City, Shandong Province, China.
Curr Treat Options Oncol. 2024 Dec;25(12):1605-1614. doi: 10.1007/s11864-024-01260-x. Epub 2024 Dec 3.
Lung cancer is the leading cause of cancer-related deaths worldwide, with about 85% of patients being diagnosed as non-small cell lung cancer (NSCLC); and most presenting with stage IV disease initially. With the continuous advancement of treatment strategies of oncology, immunotherapy with/without chemo-immunotherapy has become the first-line treatment for patients with stage IV NSCLC. However, a proportion of patients still develop resistance to the treatment regimen and experience local progression, and primary lung lesion progression is the main progression pattern of stage IV NSCLC. Preclinical and clinical studies have demonstrated the potential of radiotherapy in anti-tumor treatment and suggest that administering local radiotherapy prior to cancer progression can prolong survival. Therefore, we consider whether adding local radiotherapy before the progression of a pulmonary lesion in stage IV NSCLC patients receiving chemo-immunotherapy would be beneficial. The present review aims to explore the efficacy and safety of combining radiotherapy with immunotherapy in the treatment of stage IV NSCLC, delving into the intricacies of their underlying mechanism.
肺癌是全球癌症相关死亡的主要原因，约85%的患者被诊断为非小细胞肺癌（NSCLC）；且大多数患者初诊时即为IV期疾病。随着肿瘤治疗策略的不断进步，免疫治疗联合或不联合化疗免疫治疗已成为IV期NSCLC患者的一线治疗方法。然而，一部分患者仍会对治疗方案产生耐药性并出现局部进展，而原发性肺病灶进展是IV期NSCLC的主要进展模式。临床前和临床研究已证明放疗在抗肿瘤治疗中的潜力，并表明在癌症进展前进行局部放疗可延长生存期。因此，我们思考在接受化疗免疫治疗的IV期NSCLC患者肺部病灶进展前加用局部放疗是否有益。本综述旨在探讨放疗联合免疫治疗在治疗IV期NSCLC中的疗效和安全性，深入研究其潜在机制的复杂性。
