免疫治疗时代ⅢA/B期非小细胞肺癌的治疗:放疗视角

Treatment of stageⅢA/B non-small-cell lung cancer in era of immunotherapy:Perspective of radiotherapy

近年来,免疫治疗的研究进展使非小细胞肺癌(non-small-cell lung cancer,NSCLC)的治疗格局日新月异。因此,如何在免疫治疗的辅助下进一步优化放疗以提高局部控制是临床医师需要关注的问题。本文总结不可手术的局部晚期NSCLC(locally advanced NSCLC,LA-NSCLC)放疗的研究现状,探讨优化放疗与免疫治疗的相关研究进展,并阐述通过放疗技术、靶区勾画、淋巴结照射、亚临床病灶照射、射线选择、剂量分割和放疗搭档等的进一步优化以提升LA-NSCLC治疗疗效。总体而言,在免疫治疗时代,放疗将凸显其优势作用,有待更多大型的临床研究作进一步探索。

In recent years,the research progress of immunotherapy has made the therapeutic landscape of non-small-cell lung cancer(NSCLC)change rapidly.Therefore,how to further optimize radiotherapy and improve local control with the assistance of immunother-apy will be a problem worthy of attention.This article reviews the current status of radiotherapy for inoperable locally advanced NSCLC(LA-NSCLC),discusses the related research progress of optimized radiotherapy and immunotherapy,and further describes the optimization and improvement of the efficacy of LA-NSCLC in the aspects of radiotherapy technique,target delineation,lymph node irradiation,sub-clinical focus irradiation,radiation selection,dose fractionation and radiotherapy partner.In general,in the era of immunotherapy,radio-therapy will highlight its advantages,which needs to be further explored in more large-scale clinical studies.