立体定向放射治疗早期非小细胞肺癌的进展

立体定向放射治疗(SBRT)是指利用立体定向等中心旋转技术,将高能放射线集束聚于某一局限病变的靶区,进行大剂量照射,使之发生不可逆的生物损伤,而正常组织免受或少受照射。目前SBRT可作为不能接受手术的早期非小细胞肺癌(NSCLC)患者的标准治疗方法。关于SBRT治疗周围型肺癌和中心型肺癌的疗效肯定,但剂量分割模式未达成共识,应进一步探讨;SBRT联合免疫治疗的临床疗效有待进一步研究。因此,对SBRT治疗早期周围型、中央型NSCLC最佳剂量和分隔模式,SBRT与肺叶切除、胸腔镜手术疗效差异,SBRT联合免疫治疗等内容作一综述,以期为SBRT的临床应用提供理论依据。

Research progress on stereotactic radiation therapy for early non-small cell lung cancer

Stereotactic body radiation therapy (SBRT) refers to the use of stereotactic isocentric rotation technology, which concent rates high-energy radiation in the target area for a large dose of irradiation, causing irreversible biological damage, while the normal tissue is not or less exposed. Currently, SBRT is the standard treatment for inoperable patients with early non-small cell lung cancer (NSCLC). The efficacy of SBRT in the treatment of peripheral and central lung cancer has been validated, whereas there is no consensus on the dose and fractionation, which remains to be further explored. The clinical efficacy of SBRT combined with immunotherapy needs to be further studied. Therefore, the optimal dose and fractionation of SBRT for early peripheral and central NSCLC were discussed, the difference in the clinical efficacy among SBRT, lobectomy and thoracoscopic surgery was analyzed and the clinical efficacy of SBRT combined with immunotherapy was assessed, aiming to provide theoretical basis for the application of SBRT in clinical practice.