小细胞肺癌内科治疗新进展

小细胞肺癌（small cell lung cancer,SCLC）具有极高的增殖率、较强的早期转移倾向和较差的预后。超过三分之二的患者初诊时分期为广泛期（extensive stage-small cell lung cancer,ES-SCLC）。小细胞肺癌治疗进展缓慢,含铂化疗一直是标准治疗方案,虽然近期有效率高,但易出现耐药。近年来免疫治疗及抗血管药物的兴起,在SCLC领域出现了突破,为SCLC建立新的治疗标准。本文将SCLC的化学治疗、抗血管治疗及免疫治疗进展进行综述。     

难治性小细胞肺癌的研究进展

摘 要：小细胞肺癌( small cell lung cancer,SCLC) 是肺癌的一种特殊类型,与非小细胞肺癌相比,SCLC具有恶性程度高、侵袭性强、易发生转移的特点。SCLC对化疗和放疗都比较敏感,但化疗耐药的产生让SCLC治疗遭遇滑铁卢,其中难治性SCLC的治疗更加棘手。毫无疑问,难治性SCLC的治疗是肿瘤学界的重大挑战。全文中我们对难治性SCLC的定义、耐药机制及治疗进行叙述总结,希望为难治性SCLC的临床研究及治疗指引方向。     

上皮间质型循环肿瘤细胞在小细胞肺癌转移中的研究进展

小细胞肺癌（Small Cell Lung Cancer,SCLC）约占肺癌的20%,确诊时大约60%~70%患者已经处于晚期。与非小细胞肺癌相比,其生物学行为更差,恶性程度高,病情发展迅速,更易早期转移。目前,局限期和广泛期的小细胞肺癌治疗以全身化疗为主,小细胞肺癌患者对化疗敏感,但极易发生耐药,容易复发和转移,生存率低[1-2]。肿瘤转移是导致肿瘤患者死亡的最直接原因。目前,     

小细胞肺癌药物治疗进展

小细胞肺癌（small cell lung cancer,SCLC）约占肺癌患者的13% 。与非小细胞肺癌相比具有早期转移倾向及对一线细胞毒性化疗药物敏感的特点。目前的治疗方式包括手术、胸部及脑部放疗和化疗。以铂类联合依托泊苷为标准一线化疗,治疗后复发率较高。拓扑替康单药为标准二线化疗,新型的靶向和免疫治疗等疗效均欠佳。因此小细胞肺癌的治疗亟待有新的突破。      

小细胞肺癌靶向治疗的研究进展

摘 要：小细胞肺癌（small cell lung cancer,SCLC）约占全部肺癌的15%~20%,其生物学行为表现为恶性程度高、侵袭性强、预后差。尽管初始治疗时对放、化疗敏感,但小细胞肺癌患者容易早期出现复发转移,因疾病进展后缺乏有效治疗手段,最终导致患者死亡。近十年,靶向治疗的发展给非小细胞肺癌的治疗策略带来了巨大改变。SCLC同样具有大量体细胞突变,针对不同靶点的分子靶向药物在SCLC患者治疗中亦进行了很多探索。虽然目前没有有效的靶向药物被批准用于治疗SCLC,一些新的靶向药物在临床研究中的疗效给SCLC的治疗带来了曙光。全文将对SCLC靶向治疗的研究现状及进展进行综述。     

程序性死亡受体1及程序性死亡受体配体1抑制剂在小细胞肺癌治疗中的进展

小细胞肺癌(SCLC)约占肺癌的15%,是一种神经内分泌肿瘤,生长迅速、极具侵袭性,容易早期发生远处转移。尽管SCLC对一线化疗敏感,但容易短时间内复发。在过去的5年间,免疫治疗在SCLC中取得了一定的成果,特别是在程序性死亡受体1和程序性死亡受体配体1方面,SCLC治疗模式已经发生改变。文章对免疫检查点抑制剂在SCLC中的探索研究做一综述,以期为广大临床工作者提供参考。     

小细胞肺癌治疗新进展

小细胞肺癌（small cell lung cancer，SCLC）治疗进展缓慢，依托泊苷联合铂类和拓扑替康作为SCLC一线和二线治疗选择已经延续30余年，三线及以上SCLC一直没有标准治疗方案。因此，迫切需要新的治疗方案提高SCLC治疗的效果。最近，免疫治疗、新型化疗药物以及小分子抗血管药物的发展，在SCLC领域实现了突破，为SCLC建立新的治疗标准。随着对SCLC分子机制的理解，SCLC分子分型初步建立，分型而治的策略开始了探索。本研究对SCLC治疗的最新进展进行综述。      

小细胞肺癌分子靶向治疗的研究进展

小细胞肺癌(SCLC)是一种侵袭性恶性肿瘤,转移范围广,易对化疗药物产生耐药,导致预后不良.近年来,临床一线治疗方案仍未取得突破性进展,仍主要采用以化疗为主、放疗为辅的综合治疗,但患者易发生耐药和复发.随着科技进步、分子生物技术和生物信息学的发展,SCLC病理机制的深入研究,推动了多种基于SCLC遗传变异的靶向治疗药物的研发.本文总结了SCLC的分子生物学机制和相应靶向药物的研究进展,以及在此基础上进行的相关临床研究,有助于为SCLC的治疗探索新的治疗途径,以改善患者的预后.     

复发性小细胞肺癌治疗进展

小细胞肺癌(small cell lung cancer,SCLC)是一种高度恶性肿瘤,初始治疗对放化疗均较敏感,缓解率高,但治疗后易发生耐药并复发.虽然近年来肺癌的治疗发生了翻天覆地的变化,但SCLC复发后的治疗依然是临床上棘手的难题.鉴于复发性SCLC对现有化疗药物的耐药性严重,国内外对复发性SCLC的研究多集中在新药物研制、化疗方案优化及靶点药物的开发等临床试验上.本文对近年来复发性SCLC的化疗和精准治疗的各项研究和文献报道进行总结与评价,期望能够对复发性SCLC的临床治疗有所启发,并为复发性SCLC治疗的临床研究指引方向.     

2010年美国临床肿瘤学会年会热点——小细胞肺癌的研究进展

从生物学行为的角度可将肺癌分为小细胞肺癌(small cell lung cancer,SCLC)和非小细胞肺癌(non-small cell lung cancer,NSCLC),其中SCLC约占15%左右.SCLC恶性程度高,虽然对放疗、化疗较敏感,但预后差[1].本文就2010年美国临床肿瘤学会(American Society of Clinical Oncology,ASCO)年会上有关SCLC的研究进展做一综述.     

广泛期小细胞肺癌放射治疗进展

广泛期小细胞肺癌（extensive-stage small cell lung cancer，ES-SCLC）约占小细胞肺癌（（small cell lung cancer，SCLC）的2/3，治疗以化疗为主，辅以放疗等综合治疗。虽然SCLC对放化疗反应敏感、初治缓解率高，但几乎所有ES-SCLC都会发生复发及进展，迫切需要新的治疗策略以提高疗效。近年来，放疗在ES-SCLC中进展主要包括脑预防照射（prophylactic cranial irradiation，PCI）和胸部放疗（thoracic radiotherapy，TRT）。此外，免疫检查点抑制剂展现了良好的抗肿瘤活性，有望成为该领域治疗的重要突破口。本文将对ES-SCLC在放疗和免疫治疗以及其他治疗的临床研究进展方面进行综述。      

Recent developments in radiotherapy for small-cell lung cancer: a review by the Oncologic Group for the Study of Lung Cancer (Spanish Radiation Oncology Society)

Small-cell lung cancer (SCLC) accounts for 13% of all lung tumours. The standard treatment in patients with limited-stage disease is radiotherapy combined with chemotherapy. In extensive SCLC, the importance of consolidation thoracic radiotherapy in patients with a good treatment response has become increasingly recognized. In both limited and extensive disease, prophylactic cranial irradiation is recommended in patients who respond to treatment. New therapeutic approaches such as immunotherapy are being increasingly incorporated into the treatment of SCLC, although more slowly than in non-small cell lung cancer (NSCLC). Diverse radiation dose and fractionation schemes, administered in varying combinations with these new drugs, are being investigated. In the present study we review and update the role of radiotherapy in the treatment of SCLC. We also discuss the main clinical trials currently underway in order to identify future trends.     

免疫检查点抑制剂在小细胞肺癌中的临床研究进展

小细胞肺癌(small cell lung cancer,SCLC)是分化较差的高级别肺神经内分泌肿瘤,尽管仅占所有肺癌的14％左右,但生长迅速、较早出现转移,复发后缺少有效的治疗手段,改善SCLC治疗迫在眉睫.近年来,肿瘤免疫治疗展现了良好的前景,尤其程序性死亡受体1(programmed death1,PD-1)和细胞毒性T淋巴细胞相关抗原4(cytotoxic T-lymphocyte-associated antigen 4,CTLA-4)抑制剂的研究正在改变多种实体瘤的临床实践.SCLC与吸烟密切相关,具有较高的肿瘤突变负荷,是免疫治疗潜在理想的肿瘤类型.本文将总结免疫治疗在SCLC的临床研究进展,探讨SCLC免疫治疗中存在的问题、面临的挑战以及未来的应用前景.     

Progress in immunotherapy for small cell lung cancer

Small-cell lung cancer (SCLC) is a special type of lung cancer that belongs to highly aggressive neuroendocrine tumors. At present, radiotherapy and chemotherapy remain the mainstay of treatment for SCLC. Progress in targeted therapies for SCLC with driver mutations has been slow, and these therapies are still under investigation in preclinical or early-phase clinical trials, and research on antiangiogenic tyrosine kinase inhibitors (e.g., anlotinib) has achieved some success. Immunotherapy is becoming an important treatment strategy for SCLC after radiotherapy and chemotherapy. In this article we review the recent advances in immunotherapy for SCLC.     

Immunotherapy in Extensive-Stage Small Cell Lung Cancer

Small cell lung cancer (SCLC) remains a poorly understood disease with aggressive features, high relapse rates, and significant morbidity as well as mortality, yet persistently limited treatment options. For three decades, the treatment algorithm of SCLC has been stagnant despite multiple attempts to find alternative therapeutic options that could improve responses and increase survival rates. On the other hand, immunotherapy has been a thriving concept that revolutionized treatment options in multiple malignancies, rendering previously untreatable diseases potentially curable. In extensive stage SCLC, immunotherapy significantly altered the course of disease and is now part of the treatment algorithm in the first-line setting. Nevertheless, the important questions that arise are how best to implement immunotherapy, who would benefit the most, and finally, how to enhance responses.     

肺癌免疫治疗的研究进展

以程序性细胞死亡受体1（programmed cell death-1,PD-1）及其配体1（programmed death-ligand 1,PD-L1）抑制剂为代表的免疫治疗已经成为肺癌非常重要的治疗手段,在非小细胞肺癌（non-small cell lung cancer,NSCLC）和小细胞肺癌（small cell lung cancer,SCLC）的治疗中均取得了突破性进展,免疫单药、免疫联合化疗、双免疫联合用药相继取得成功,极大改变了肺癌的治疗形式,使肺癌患者实现长期生存,成为肺癌重要的治疗手段。在不断取得突破的同时,针对肺癌免疫治疗领域也在进行着更深层次的研究,包括用药模式的优化、新靶点药物研发、克服耐药策略的探索等,本文将重点介绍肺癌免疫治疗的相关研究进展。      

An Overview of the Role of Radiotherapy in the Treatment of Small Cell Lung Cancer – A Mainstay of Treatment or a Modality in Decline?

AimsSmall cell lung cancer (SCLC) accounts for about 15% of all lung cancers. Chemotherapy, immunotherapy and radiotherapy all play important roles in the management of SCLC. The aim of this study was to provide a comprehensive overview of the role and evidence of radiotherapy in the cure and palliation of SCLC.Materials and methodsThe search strategy included a search of the PubMed database, hand searches, reference lists of relevant review articles and relevant published abstracts. ClinicalTrials.gov was also queried for relevant trials.ResultsThoracic radiotherapy improves overall survival in limited stage SCLC, but the timing and dose remain controversial. The role of thoracic radiotherapy in extensive stage SCLC with immunotherapy is the subject of several ongoing trials. Current evidence supports the use of prophylactic cranial irradiation (PCI) for limited stage SCLC but the evidence is equivocal in extensive stage SCLC. Whole brain radiotherapy is well established for the treatment of brain metastases but evidence is rapidly accumulating for the use of stereotactic radiosurgery. Further studies will define the role of PCI, whole brain radiotherapy and hippocampal avoidant PCI in the immunotherapy era.ConclusionRadiotherapy is an essential component in the multimodality management of SCLC. Technological advances have allowed safer delivery of radiotherapy with reduced toxicities. Discussion at multidisciplinary team meetings is important to ensure radiotherapy is considered and offered in appropriate patients.     

小细胞肺癌免疫治疗相关生物标志物研究进展

最近30年来小细胞肺癌(small cell lung cancer,SCLC)的治疗手段无明显突破,整体预后也无显著改善.随着免疫治疗时代的开启,免疫检查点抑制剂在SCLC治疗中取得了重大进展,但整体获益仍有限.如何筛选获益人群以进一步提高免疫治疗效果是当下SCLC研究的热点问题之一.通过概述SCLC现状,聚焦SCL...