EGFR敏感突变的晚期非小细胞肺癌TKI联合肺部病灶SBRT的临床研究进展

目前表皮生长因子受体-酪氨酸激酶抑制剂(EGFR-TKI)已作为EGFR突变的晚期非小细胞肺癌(NSCLC)患者的标准一线治疗,但EGFR-TKI治疗后不可避免的会产生获得性耐药而导致疾病进展,其中约50%患者为肺部原发灶和/或初始转移灶进展。放疗作为主要的局部治疗手段,在晚期肿瘤患者的管理中有着不可替代作用。应用射波刀实施的体部立体定向放疗(SBRT)是最先进的放疗技术,能够更好地满足临床需求。近年来,基于上述复发模式的思考,采用肺部病灶SBRT联合EGFR-TKI改善患者无瘤进展生存的治疗模式备受关注,本文将对该联合治疗策略的临床研究进展进行综述。

Clinical research progress on EGFR-TKI combined with pulmonary SBRT in advanced non-small cell lung cancer with EGFR-sensitive mutations

Epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) has become the standard first-line treatment for advanced non-small cell lung cancer (NSCLC) patients with EGFR-sensitive mutations. However, acquired resistance cannot be avoided during the targeted treatment of EGFR-TKI, which may lead to the progression of NSCLC. Among them, approximately 50% of patients present with primary lung lesions and/or initial metastastic lesion progression. As a major local treatment, radiation therapy plays an irreplaceable role in the management of patients with advanced cancer. Stereotactic body radiation therapy (SBRT), which is implemented with the Cyberknife, is the most advanced radiation therapy technology to better meet clinical needs. In recent years, based on the abovementioned patterns of tumor recurrence, the treatment mode of pulmonary-lesion SBRT combined with EGFR-TKI can improve the tumor-free survival in advanced NSCLC patients, which has attracted widespread attention. In this article, the clinical research progresses on this combined therapeutic strategy were reviewed.