广泛期小细胞肺癌胸部放疗的应用价值及研究进展

Application value and research progress in thoracic radiotherapy for extensive-stage small cell lung cancer

小细胞肺癌(SCLC)预后极差,容易早期发生局部复发和远处转移,其中2/3的初诊患者为广泛期。对于广泛期小细胞肺癌(ES-SCLC),既往的标准治疗以含铂双药的全身化疗为主。在化疗时代,一些研究表明,对系统治疗有效的ES-SCLC患者行巩固胸部放疗,可以带来生存获益。然而近年来随着ES-SCLC的一线治疗进入免疫时代、影像分期手段的提高、精准放疗技术的进步,胸部放疗的获益性引发了广泛关注及一定的争议。本文就现代诊疗技术下,胸部放疗在ES-SCLC中的应用价值及放疗联合免疫治疗的最新进展进行综述。

Small cell lung cancer(SCLC)is characterized by rapid proliferation and high propensity for local recurrence and widespread metastasis,which yields extremely poor prognosis.Approximately 2/3 of patients present with extensive-stage disease(ES-SCLC)at initial diagnosis.For ES-SCLC,the combination platinum-based chemotherapy has been the standard regimen for the past few decades.In the era of chemotherapy,multiple studies have shown the benefit of thoracic radiotherapy(TRT)for patients who responded to chemotherapy.However,with the first-line treatment of ES-SCLC shifting into the immune era,as well as the advances in diagnostic imaging modality and radiation technology,the benefit of TRT has caused a widespread controversy.In this article,the value of TRT for ES-SCLC and the latest progress in the radioimmunotherapy combination mode for ES-SCLC were reviewed.