局部晚期NSCLC:杜尔瓦卢马布时代复发现实模式的概述 (LEOPARD试验)
P Ciammella1, F Iori2, P Borghetti3
1Radiation Oncology Unit, Azienda USL-IRCCS di Reggio Emilia 42124 Reggio Emilia, Italy.
Lung cancer (Amsterdam, Netherlands)
|August 28, 2025
概括
在III期NSCLC中,化学放射治疗和杜瓦卢马布后的复发是常见的,最常见的模式是寡重复复发. 以转移为导向的疗法,特别是放射治疗,早期治疗小重复性病例可显著改善整体存活率.
科学领域:
- 癌症学
- 肺病学
- 放射治疗
背景情况:
- 化学放射治疗 (CRT) 和杜尔瓦卢马布巩固后的复发是不可切除的第三阶段非小细胞肺癌 (NSCLC) 的挑战.
- PACIFIC试验确立了护理标准,但进展后的治疗需要进一步调查.
研究的目的:
- 通过PACIFIC疗法治疗的现实阶段非切除性NSCLC患者的复发模式和救援治疗结果.
- 为经历复发的患者提供关于后进展治疗策略的见解.
主要方法:
- 对166名无法切除的第三期NSCLC患者进行了回顾性分析,这些患者接受了CRT治疗,随后接受了杜尔瓦卢马布治疗.
- 复发的分类为少复发 (≤3个病变) 或多复发.
- 评估救援策略及其对整体存活率的影响.
主要成果:
- 在平均33个月的随访后,56%的患者出现了复发.
- 主要是少量发生 (72%),通常涉及辐射场外的肺部和大脑.
- 低频患者 (41个月) 与多频患者 (19个月) 的中位寿命显著更长. 在稀少的病例中,救援RT或CRT的效果比单独的化疗更好.
结论:
- 在CRT和杜尔瓦卢马布治疗后,小细胞复发是不可切除的III期NSCLC的主要复发模式.
- 以转移为导向的疗法,特别是放射疗法,可改善少量复发病例的存活率.
- 分层复发模式和整合本地救援治疗对于个性化管理至关重要.
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