Non-small cell lung cancer(NSCLC) is a heterogeneous disease accounting for approximately 85% of all lung cancers. Only 17% of patients are diagnosed at an early stage. Treatment is multidisciplinary and radiotherapy ...Non-small cell lung cancer(NSCLC) is a heterogeneous disease accounting for approximately 85% of all lung cancers. Only 17% of patients are diagnosed at an early stage. Treatment is multidisciplinary and radiotherapy plays a key role in all stages of the disease. More than 50% of patients with NSCLC are treated with radiotherapy(curative-intent or palliative). Technological advancesincluding highly conformal radiotherapy techniques, new immobilization and respiratory control systems, and precision image verification systems-allow clinicians to individualize treatment to maximize tumor control while minimizing treatment-related toxicity. Novel therapeutic regimens such as moderate hypofractionation and advanced techniques such as stereotactic body radiotherapy(SBRT) have reduced the number of radiotherapy sessions. The integration of SBRT into routine clinical practice has radically altered treatment of early-stage disease. SBRT also plays an increasingly important role in oligometastatic disease. The aim of the present guidelines is to review the role of radiotherapy in the treatment of localized, locally-advanced, and metastatic NSCLC. We review the main radiotherapy techniques and clarify the role of radiotherapy in routine clinical practice. These guidelines are based on the best available evidence. The level and grade of evidence supporting each recommendation is provided.展开更多
Immunotherapy has represented one of the main medical revolutions of recent decades,and is currently a consolidated treatment for different types of tumors at different stages and scenarios,and is present in a multitu...Immunotherapy has represented one of the main medical revolutions of recent decades,and is currently a consolidated treatment for different types of tumors at different stages and scenarios,and is present in a multitude of clinical trials.One of the diseases in which it is most developed is non-small cell lung cancer.The combination of radiotherapy and immunotherapy in cancer in general and lung cancer in particular currently represents one of the main focuses of basic and clinical research in oncology,due to the synergy of this interaction,which can improve tumor response,resulting in improved survival and disease control.In this review we present the biochemical and molecular basis of the interaction between radiotherapy and immunotherapy.We also present the current clinical status of this interaction in each of the stages and cases of non-small cell lung cancer,with the main results obtained in the different studies both in terms of tumor response and survival as well as toxicity.Finally,we mention the main studies underway and the challenges of this interaction in the coming years,including how these treatments should be combined to achieve the greatest efficacy with the fewest possible side effects(dose,type of radiotherapy and drugs,sequence of treatments).展开更多
文摘Non-small cell lung cancer(NSCLC) is a heterogeneous disease accounting for approximately 85% of all lung cancers. Only 17% of patients are diagnosed at an early stage. Treatment is multidisciplinary and radiotherapy plays a key role in all stages of the disease. More than 50% of patients with NSCLC are treated with radiotherapy(curative-intent or palliative). Technological advancesincluding highly conformal radiotherapy techniques, new immobilization and respiratory control systems, and precision image verification systems-allow clinicians to individualize treatment to maximize tumor control while minimizing treatment-related toxicity. Novel therapeutic regimens such as moderate hypofractionation and advanced techniques such as stereotactic body radiotherapy(SBRT) have reduced the number of radiotherapy sessions. The integration of SBRT into routine clinical practice has radically altered treatment of early-stage disease. SBRT also plays an increasingly important role in oligometastatic disease. The aim of the present guidelines is to review the role of radiotherapy in the treatment of localized, locally-advanced, and metastatic NSCLC. We review the main radiotherapy techniques and clarify the role of radiotherapy in routine clinical practice. These guidelines are based on the best available evidence. The level and grade of evidence supporting each recommendation is provided.
文摘Immunotherapy has represented one of the main medical revolutions of recent decades,and is currently a consolidated treatment for different types of tumors at different stages and scenarios,and is present in a multitude of clinical trials.One of the diseases in which it is most developed is non-small cell lung cancer.The combination of radiotherapy and immunotherapy in cancer in general and lung cancer in particular currently represents one of the main focuses of basic and clinical research in oncology,due to the synergy of this interaction,which can improve tumor response,resulting in improved survival and disease control.In this review we present the biochemical and molecular basis of the interaction between radiotherapy and immunotherapy.We also present the current clinical status of this interaction in each of the stages and cases of non-small cell lung cancer,with the main results obtained in the different studies both in terms of tumor response and survival as well as toxicity.Finally,we mention the main studies underway and the challenges of this interaction in the coming years,including how these treatments should be combined to achieve the greatest efficacy with the fewest possible side effects(dose,type of radiotherapy and drugs,sequence of treatments).
