免疫治疗时代不可手术局部晚期非小细胞肺癌的治疗：现状与展望

doi:10.19401/j.cnki.1007-3639.2022.06.003

摘要/Abstract

摘要：

PACIFIC研究拉开了不可手术局部晚期非小细胞肺癌（locally advanced non-small cell lung cancer,LA-NSCLC）免疫治疗新时代的序幕,同时也提出了如何将放化疗与免疫治疗有机整合及进一步优化的新命题。本文对不可手术LA-NSCLC的治疗进展进行综述,旨在探讨免疫治疗背景下LA-NSCLC的研究现况和未来方向。本文将汇总PACIFIC研究的更新数据和这个模式在特殊人群,如老年、程序性死亡[蛋白]配体-1（programmed death ligand-1,PD-L1）阴性、表皮生长因子受体（epidermal growth factor receptor,EGFR）基因突变的研究进展,探讨放化疗和免疫治疗的最佳时序安排。回顾放疗在剂量分割、靶区勾画、射线选择方面的技术进步和实施优化的探索,并展望其在免疫治疗时代的应用前景。

关键词: 非小细胞肺癌, 免疫治疗, 放射治疗, 化学疗法

Abstract:

The PACIFIC trial uncovered a new era of immunotherapy in the multi-disciplinary treatment of unresectable locally advanced non-small cell lung cancer (LA-NSCLC), but also proposed a new question of how to further optimize radiotherapy and chemotherapy, in order to maximize synergistic effects with immunotherapy. The treatment progress of unresectable LA-NSCLC was reviewed in the context of immunotherapy. Updated data of the PACIFIC trial along with the research progress among special populations, especially for elderly patients, programmed death ligand-1 (PD-L1) expression negative and epidermal growth factor receptor (EGFR) gene mutant were summarized. Meanwhile, the optimal sequence of radiotherapy, chemotherapy and immunotherapy, the technical advancement and implementation of radiotherapy, including dose fractionation, target delineation and ray selection, were discussed, as well as its application prospect in the era of immunotherapy.

Key words: Non-small cell lung cancer, Immunotherapy, Radiotherapy, Chemotherapy

中图分类号:

R734.2

虞思来, 倪建佼, 朱正飞. 免疫治疗时代不可手术局部晚期非小细胞肺癌的治疗：现状与展望[J]. 中国癌症杂志, 2022, 32(6): 487-498.

YU Silai, NI Jianjiao, ZHU Zhengfei. Treatment of unresectable locally advanced non-small cell lung cancer in the era of immunotherapy: status and prospects[J]. China Oncology, 2022, 32(6): 487-498.

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