非小细胞肺癌放疗联合免疫治疗相关进展

Progress in radiotherapy combined with immunotherapy for non-small cell lung cancer

肺癌是死亡率最高的癌症类型,许多患者确诊时已失去手术机会。晚期非小细胞肺癌(non-small cell lung cancer,NSCLC)的预后差,放疗和化疗是主要的治疗手段。随着免疫检查点抑制剂(immune checkpoint inhibitor,ICI)的应用,显著改善了患者的生存。然而,单用ICI的应答率低,而与放疗联合应用时可以提高免疫治疗的疗效,特别是低剂量放疗,既可以控制局部病灶,还能够增强全身的抗肿瘤作用。目前,对于放疗联合免疫治疗的时序、疗效预测指标以及放疗分割方式、剂量和部位的选择等,仍存有争议。本文综述了局部晚期和晚期NSCLC放疗联合免疫治疗的最新进展,以期为临床决策提供参考。

Lung cancer is the type of cancer with the highest mortality rate,and many patients are already in advanced stage when diagnosed.Advanced non-small cell lung cancer(NSCLC)has a poor prognosis,and radiotherapy and chemotherapy are the main treatment methods.With the application of immune checkpoint inhibitors(ICIs),the survival of patients has been greatly improved.However,the response rate of ICIs alone is low,which can improve the efficacy of immunotherapy when combined with radiotherapy.Especially,the addition of low-dose radiotherapy can not only control local lesions but also enhance the systemic anti-tumor effect.At present,there are still controversies regarding the timing sequence,prediction biomarker,radiotherapy segmentation method,dose and site of the combination of radiotherapy and immunotherapy for advanced NSCLC.This paper reviews the progress in the combination of radiotherapy and immunotherapy for locally advanced and advanced NSCLC,providing references for clinical decision-making.