非小细胞肺癌围手术期免疫治疗时代的麻醉思考

Anesthesia consideration in the era of perioperative immunotherapy for non-small cell lung cancer

随着非小细胞肺癌(non-small cell lung cancer,NSCLC)围手术期免疫治疗时代的到来,胸外科的麻醉管理面临新的机会和挑战。不同麻醉方式和药物的选择会影响免疫功能和肿瘤生长转移,以免疫检查点抑制剂为代表的免疫治疗能够激活抗肿瘤免疫,影响局部和系统性免疫。麻醉和免疫治疗可能会产生不可预知的交互作用。本文将对麻醉方式和药物以及免疫治疗对NSCLC免疫状态和预后的影响进行综述,以期为NSCLC围手术期免疫治疗患者的麻醉管理提供新的思路。

With the advent of perioperative immunotherapy for non-small cell lung cancer(NSCLC),the management of anesthesia in thoracic surgery has become challenging.Different choices for anesthesia modalities and drugs affect immune function,tumor growth,and metastasis.Cancer immunotherapy with immune checkpoint inhibitors activates antitumor immunity,affecting local and systemic immune response.Anesthesia and immunotherapy may cause unpredictable interactions.This review examines the impact of anesthetic modalities and pharmaceuticals along with immunotherapy on the immune status and prognosis of NSCLC,offering new insights for their perioperative management in patients with NSCLC.