Liu Lei, Mao Yilong, Guo Leilei, Li Chencong, Wang Yiqian
Department of Radiation Oncology, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China.
Front Oncol. 2025 Jan 21;14:1523743. doi: 10.3389/fonc.2024.1523743. eCollection 2024.
Non-small cell lung cancer (NSCLC) is still the disease with the highest incidence rate among malignant tumors, in which NSCLC under N2 stage has obvious survival differences among different patients due to its high heterogeneity. For NSCLC under this stage, the current treatment options are: preoperative neoadjuvant therapy, surgical treatment, postoperative adjuvant chemotherapy, postoperative adjuvant radiotherapy (PORT), Postoperative adjuvant targeted therapy and postoperative adjuvant immunotherapy. Whether postoperative adjuvant radiotherapy is routinely administered to patients with pN2 remains controversial in clinical application. Meanwhile, the booming development of adjuvant targeted therapy and adjuvant immunotherapy also provides newer therapeutic options for the prognosis of postoperative pN2 stage NSCLC, and some new markers will guide the adaptive application of immune drugs in the future. This article analyzes the current stage of therapeutic advances in operable stage N2 non-small cell lung cancer, and discusses in detail in this article the therapeutic controversy of postoperative adjuvant radiotherapy in pN2 stage non-small cell lung cancer, so as to explore a more reasonable treatment mode for future patients with stage N2 non-small cell lung cancer.
非小细胞肺癌(NSCLC)仍然是恶性肿瘤中发病率最高的疾病,其中N2期NSCLC由于其高度异质性,不同患者之间的生存差异明显。对于该阶段的NSCLC,目前的治疗选择包括:术前新辅助治疗、手术治疗、术后辅助化疗、术后辅助放疗(PORT)、术后辅助靶向治疗和术后辅助免疫治疗。对于pN2患者是否常规进行术后辅助放疗在临床应用中仍存在争议。同时,辅助靶向治疗和辅助免疫治疗的蓬勃发展也为术后pN2期NSCLC的预后提供了更新的治疗选择,一些新的标志物将指导未来免疫药物的适应性应用。本文分析了可手术切除的N2期非小细胞肺癌治疗进展的现状,并详细讨论了pN2期非小细胞肺癌术后辅助放疗的治疗争议,以便为未来N2期非小细胞肺癌患者探索更合理的治疗模式。