非小细胞肺癌放射治疗研究进展

目的 肺癌是全球男性肿瘤患者首位死亡原因,也是我国发病率、死亡率第1位的恶性肿瘤,约80%~85%肺癌患者是非小细胞肺癌(non-small cell lung cancer,NSCLC).本文对放疗在NSCLC的治疗现状和研究进展进行综述.方法 检索Pubmed和CNKI期刊全文数据库,以"肺癌与放疗、放疗联合靶向治疗、放疗联合免疫治疗"为关键词,检索2005-11-01-2016-11-30关于NSCLC放疗的文献,共检索文献篇653篇.纳入标准:(1)放疗在NSCLC的应用;(2)放疗与靶向治疗的联合;(3)放疗与免疫治疗联合应用的研究.根据纳入标准最后纳入分析44篇文献.结果早期肺癌患者可选择手术或立体定向放射治疗(stereotacticbodyradiationtherapy,SBRT),尤其是高龄、心肺功能不全及不能耐受手术的Ⅰ期肺癌患者,SBRT已经成为标准的治疗手段,不仅靶区小、单次照射剂量高、照射次数少,并且将邻近正常组织剂量控制在可接受范围.对于中晚期失去手术机会的患者,靶向治疗可以通过抑制放疗引起的DNA双链断裂的损伤修复、诱导肿瘤细胞凋亡及影响细胞周期等机制增加放疗敏感性.而免疫治疗与放疗的结合,可以促进机体的免疫反应,增加针对肿瘤细胞的特异性抗体,从而发挥抗肿瘤作用,尤其是放疗与免疫治疗结合后引起的"远位效应".结论放疗在NSCLC的治疗中有独特的优势,与其他治疗方法的结合为肺癌患者提供了新的治疗模式.

Current status and progress of radiotherapy for non-small cell lung cancer

Lung cancer is a kind of malignancies with the highest morbidity and mortality in China.Lung cancer can be divided into two groups, including non-small cell lung cancer (NSCLC) and small cell lung cancer.About 80%-85% lung cancer patients had NSCLC.We summarized the application of radiotherapy in NSCLC, the combination of radiotherapy and other treatments as well as the basic studies on radiotherapy.METHODS We searched papers with "lung cancer, radiotherapy, targeted therapy, immunotherapy" as key words in pubmed and CNKI databases.As a result, we got 653 papers from Nov.2005 to Nov.2016.According to the inclusion criteria, we summarized 44 papers.RESULTS Lung cancer patients with early diseases can be treated with surgery or SBRT (stereotactic body radiation therapy).However, most patients were diagnosed at middle or late disease stage and, thus, lost the opportunity to have surgery.Combination of radiotherapy and other treatments is commonly used for these patients.CONCLUSION Radiotherapy is an integral part in the treatment of lung cancer, combined with other therapies provide a new treatment model.