在免疫疗法时代,用于扩散阶段小细胞肺癌的放射治疗
Huanhuan Li1, Yangzhi Zhao2, Tiangang Ma3
1Department of Radiation Oncology, The Second Affiliated Hospital of Jilin University, Changchun, China.
Frontiers in immunology
|September 13, 2023
概括
放射治疗,包括巩固性胸部放射治疗和预防性头骨辐射,当与免疫治疗相结合时,可能会改善扩散阶段小细胞肺癌 (ES-SCLC) 的结果. 需要进一步的研究来澄清它的作用和优化治疗策略.
科学领域:
- 在瘤学瘤学.
- 辐射瘤学 辐射瘤学
- 医学瘤学 医学瘤学
背景情况:
- 化疗免疫疗法是扩散阶段小细胞肺癌 (ES-SCLC) 的标准第一线治疗方法,但完全反应率很低 (0.8%-2.5%).
- ES-SCLC对放射治疗很敏感,这表明将其纳入治疗方案可能有好处.
- 放射治疗在ES-SCLC现代免疫治疗中的作用需要进一步研究.
研究的目的:
- 审查目前关于各种放射治疗方式与ES-SCLC免疫治疗相结合的可行性和潜在益处的证据.
- 探索巩固性胸部放射治疗 (cTRT),预防性部辐射 (PCI) 和在免疫疗法时代缓解性放射治疗的不断变化的作用.
- 讨论在接受免疫治疗的ES-SCLC患者中用于大脑转移 (BM) 的整脑辐射疗法 (WBRT) 与立体性放射外科手术 (SRS) 的有争议的使用.
主要方法:
- 对ES-SCLC中放射治疗和免疫治疗现有研究的文献综述.
- 讨论关于SCLC中cTRT,PCI,WBRT和SRS的先前研究.
- 分析免疫治疗对不同辐射技术的疗效和适应症的影响.
主要成果:
- 巩固性胸部放射治疗 (cTRT) 已显示出降低疾病进展和改善ES-SCLC患者的生存率的潜力,但其与免疫治疗的疗效尚未得到充分证实.
- 预防性脑辐射 (PCI) 减少大脑转移 (BM) 在有限阶段的SCLC,但其在ES-SCLC的常规使用与免疫治疗是有争议的.
- 息性放射治疗仍然对症状转移性疾病至关重要,即使是免疫疗法,而SRS与WBRT对有限的BM的作用仍在调查中.
结论:
- 放射治疗,包括cTRT和PCI,在与免疫治疗相结合时,有望改善ES-SCLC的结果.
- 在免疫疗法时代,PCI的最佳使用和SRS和WBRT之间的选择需要进一步的前性研究.
- 息性放射疗法对于ES-SCLC晚期疾病患者的症状管理至关重要.
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