先进诊疗技术下小细胞肺癌脑预防照射临床价值与研究进展

Clinical value and research progress on prophylactic cranial irradiation in small cell lung cancer under advanced diagnosis and treatment technology

小细胞肺癌(SCLC)恶性程度高,侵袭性强,易发生颅脑转移。现有指南均推荐脑预防照射(PCI)作为初始系统性治疗后达到完全缓解的SCLC患者的标准治疗方案。但在MRI广泛应用于颅脑转移诊断的今天,放疗同时免疫治疗及分子靶向治疗的联合治疗方案广泛应用于肺癌,PCI在SCLC治疗中的价值受到质疑并面临挑战。而应用海马保护技术及相关药物减少PCI后神经认知功能损伤成为研究热点。本文将近期文献报道的PCI相关研究结果进行综述,为SCLC患者选择最适合的PCI个体化治疗方案提供参考。

Small cell lung cancer(SCLC)is highly malignant,aggressive and prone to brain metastasis.Several guidelines recommend prophylactic cranial irradiation(PCI)as the standard treatment for SCLC patients who have achieved complete remission after initial systemic treatment.However,in the modern era,magnetic resonance imaging(MRI)has been commonly applied in the diagnosis of brain metastasis,while radiotherapy combined with immunotherapy and molecular targeted therapy are widely adopted in the treatment of lung cancer.The value of PCI in SCLC has been questioned and challenged.In addition,the application of hippocampal avoidance and drugs to reduce the damage of neurocognitive function after PCI has also become a research hotspot.In this article,the research progress on PCI was reviewed with the latest literature,aiming to provide reference for selecting the most suitable individualized treatment for patients receiving PCI.