药物选择 剂量 分割 顺序对放疗联合免疫治疗晚期非小细胞肺癌疗效的影响

非小细胞肺癌(non-small cell lung cancer，NSCLC)约占肺癌总数的85%，53%的患者在确诊时即为晚期。近年来，免疫检查点抑制剂(immune checkpoint inhibitors，ICIs)在晚期肿瘤治疗中效果显著。放疗在晚期NSCLC主要用于局部姑息治疗。研究显示免疫治疗协同放疗治疗晚期NSCLC与单独放疗或免疫治疗相比，可改善患者的无进展生存(progression-free survival，PFS)和总生存(overall survival，OS)，且不增加3级以上不良反应发生率。但ICIs的选择、放疗剂量、分割方式及联合治疗顺序仍未完全阐明。本文就免疫治疗联合放疗在晚期NSCLC中的临床研究进展作一综述，为临床选择提供参考。 

Effects of drug option as well as dose,fraction,and sequence of radiotherapy combined with immunotherapy in advanced non-small-cell lung cancer

Non-small cell lung cancer(NSCLC)accounts for approximately 85%of clinical lung cancer cases;53%of patients are at an advanced stage at initial diagnosis.In recent years,immune checkpoint inhibitors(ICIs)have achieved remarkable success in the treatment of late-stage cancer.Radiotherapy is commonly used in the palliative treatment of advanced NSCLC.Studies have shown that combining immunotherapy with radiotherapy in advanced NSCLC improves progression-free survival(PFS)and overall survival(OS)compared with monotherapy and does not increase the incidence of adverse effects above grade III.However,the choice of ICIs,the dose and fraction of radiotherapy,and the sequence of combination treatments have not been clarified.This article reviews the clinical research progress of immunotherapy combined with radiotherapy in advanced NSCLC,and provides a reference for clinical practice.