广泛期小细胞肺癌一线免疫联合化疗后胸部巩固放疗研究进展

Advances in thoracic consolidation radiotherapy after first-line immunotherapy combined with chemotherapy for extensive stage small cell lung cancer

小细胞肺癌约占原发性支气管肺癌的13%~17%,因其生长速度快、恶性程度高、转移早及预后差等特点,约70%的患者在确诊时已发展为广泛期。虽然绝大多数广泛期小细胞肺癌患者对初始化疗敏感,但短期内局部复发及远处转移仍不可避免。免疫治疗时代的到来为攻克这一临床难题带来了曙光。目前,免疫检查点抑制剂联合化疗已经成为广泛期小细胞肺癌一线治疗新策略,有效延长了患者生存。尽管如此,患者初始系统治疗后胸部病灶复发风险仍然较高,胸部巩固放疗的加入能否改善当前现状,尚待明确。文章汇总了一线化疗联合免疫治疗后行胸部巩固放疗这一模式在广泛期小细胞肺癌中的最新研究进展,旨在为临床实践提供参考依据。

Small cell lung cancer(SCLC)accounts for about 13%~17%of primary bronchial lung cancer.Due to its rapid growth rate,aggressive behavior,early metastasis and poor prognosis,about 70%of patients were diagnosed with extensive-stage(ES)disease.Although most ES-SCLC patients are sensitive to initial chemotherapy,local recurrence and distant metastasis develop in the short term.Immunotherapy has brought the dawn to overcome it.At present,immune checkpoint inhibitor combined with chemotherapy has become an important strategy as first-line therapy for ES-SCLC.Nevertheless,patients are still at a high risk of chest lesion recurrence after initial systemic therapy.Whether the addition of thoracic consolidation radiotherapy(TRT)can reduce chest lesion recurrence rate remains to be determined.In this review,we summarized the latest research progress in the mode of first-line chemotherapy combined with immunotherapy followed by TRT in ES-SCLC,aiming to provide reference for clinical practice.