放疗在广泛期小细胞肺癌中的应用研究进展

Progress in the application of radiotherapy in extensive-stage small cell lung cancer

过去30余年,依托泊苷+铂类的双药化疗方案始终是广泛期小细胞肺癌(ES-SCLC)的标准治疗模式,而放疗在ES-SCLC中的应用始终未得到明确。近年来免疫治疗在ES-SCLC中取得重大突破,目前免疫治疗联合基础化疗的方案已经成为ES-SCLC的标准治疗。而随着越来越多的证据提出放疗与免疫治疗间存在不可忽视的协同抗肿瘤效应,在免疫治疗时代放疗对ES-SCLC的应用价值也被重新提起。如今胸部放疗和脑部放疗联合免疫治疗的早期临床研究已经对此进行了初步的探索,低剂量放疗在ES-SCLC中的引入也为研究者提出了新的探索方向,本文就放疗在广泛期小细胞肺癌的应用研究进展进行综述。

The two-agent chemotherapy regimen of etoposide+platinum has always been the standard treatment modality for extensive-stage small cell lung cancer(ES-SCLC)during the past 30 years.However,the application of radiotherapy in ES-SCLC has not been clarified.Immunotherapy has made significant breakthroughs in ES-SCLC in recent years.Currently,the regimen of immunotherapy combined with basic chemotherapy has become the standard of care for ES-SCLC.As more and more evidence suggests that there is a non-negligible synergistic anti-tumour effect between radiotherapy and immunotherapy,the application value of radiotherapy in ES-SCLC has been reintroduced in the era of immunotherapy.At present,early clinical studies of thoracic radiotherapy(TRT)and brain radiotherapy(BRT)combined with immunotherapy have been initially explored in this regard,and the introduction of low-dose radiotherapy(LDRT)in ES-SCLC has also proposed a new direction of exploration.In this article,the progress in the application of radiotherapy in ES-SCLC was reviewed.