广泛期小细胞肺癌放射治疗进展

陈思颖; 孙基峰; 赵路军; 王平; 刘宁波

doi:10.3969/j.issn.1000-8179.2019.12.433

广泛期小细胞肺癌放射治疗进展

doi: 10.3969/j.issn.1000-8179.2019.12.433

天津医科大学肿瘤医院放疗科，国家肿瘤临床医学研究中心，天津市肿瘤防治重点实验室，天津市恶性肿瘤临床医学研究中心（天津市300060）

基金项目:

国家自然科学基金项目 81372518

天津市科委面上项目 16JCYBJC25300

详细信息

作者简介:
陈思颖专业方向为肿瘤放治疗的临床诊治。E-mail：caracsy@outlook.com

通讯作者:
刘宁波 liuningbo@tjmuch.com

计量
- 文章访问数: 156
- HTML全文浏览量: 7
- PDF下载量: 16
- 被引次数: 0
出版历程
- 收稿日期: 2019-04-17
- 修回日期: 2019-06-13
- 刊出日期: 2019-06-30

Advances in radiotherapy for extensive-stage cell lung cancer

Depatment of Radiotherapy, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer,Tianjin Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin 300060, China

Funds:

the National Natural Science Foundation of China 81372518

Tianjin Science and Technology Commission Project 16JCYBJC25300

More Information

Corresponding author: Ningbo Liu, E-mail: liuningbo@tjmuch.com

摘要

摘要: 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。
- 广泛期小细胞肺癌 /
- 放疗 /
- 脑预防照射 /
- 免疫治疗
Abstract: Extensive-stage small cell lung cancer (ES-SCLC) accounts for approximately two-thirds of all SCLCs. Chemotherapy is still the main treatment, supplemented with radiotherapy and other comprehensive treatments. Although sensitive to chemotherapy and radiotherapy, almost all ES-SCLCs are vulnerable to treatment resistance and have high recurrence rates. Therefore, novel therapies are needed to improve treatment efficacy. The recent advances in radiotherapy for ES- SCLC include prophylactic cranial irradiation (PCI) and thoracic radiotherapy (TRT). Moreover, immunotherapy has shown good antitumor activity, and immune-checkpoint inhibitors may become an important breakthrough in SCLC treatment. This article briefly reviewed the clinical research on radiotherapy and immunotherapy for advanced-stage SCLC.
- extensive-stage small cell lung cancer(ES-SCLC) /
- radiotherapy /
- prophylactic cranial irradiation (PCI) /
- immunotherapy

HTML全文

参考文献(31)

[1]	Yip D, Harper PG. Predictive and prognostic factors in small cell lung cancer current status[J]. Lung Cancer, 2000, 28(3):173-185. https://www.ncbi.nlm.nih.gov/pubmed/10812187
[2]	Parikh M, Riess J, Lara PN. New and emerging developments in extensive-stage small cell lung cancer therapeutics[J]. Curr Opin Oncol, 2016, 28(2):97-103. doi: 10.1097/CCO.0000000000000264
[3]	George J, Lim JS, Jang SJ, et al. Comprehensive genomic profiles of small cell lung cancer[J]. Nature, 2015, 524(7563):47-53. doi: 10.1038/nature14664
[4]	Aupérin A, Arriagada R, Pignon JP, et al. Prophylactic cranial irradiation for patients with small-cell lung cancer in complete remission. Prophylactic Cranial Irradiation Overview Collaborative Group[J]. N Engl J Med, 1999, 341(7):476-484. doi: 10.1056/NEJM199908123410703
[5]	Meert AP, Paesmans M, Berghmans T, et al. Prophylactic cranial irradiation in small cell lung cancer: a systematic review of the literature with meta-analysis[J]. BMC Cancer, 2001, 1:5. doi: 10.1186/1471-2407-1-5
[6]	Slotman B, Faivre-Finn C, Kramer G, et al. Prophylactic cranial irradiation in extensive small-cell lung cancer[J]. N Engl J Med, 2007, 357 (7):664-672. doi: 10.1056/NEJMoa071780
[7]	Slotman BJ, Mauer ME, Bottomley A, et al. Prophylactic cranial irradiation in extensive disease small- cell lung cancer: short- term health-related quality of life and patient reported symptoms: results of an international Phase Ⅲ randomized controlled trial by the EORTC radiation oncology and lung cancer groups[J]. J Clin Oncol, 2009, 27(1):78-84. doi: 10.1200/JCO.2008.17.0746
[8]	Takahashi T, Yamanaka T, Seto T, et al. Prophylactic cranial irradiation versus observation in patients with extensive- disease smallcell lung cancer: a multicentre, randomised, open-label, phase 3 trial[J]. Lancet Oncol, 2017, 18(5):663-671. doi: 10.1016/S1470-2045(17)30230-9
[9]	Chen Y, Li J, Hu Y, et al. Prophylactic cranial irradiation could improve overall survival in patients with extensive small cell lung cancer: A retrospective study[J]. Strahlenther Onkol, 2016, 192(12):905-912. doi: 10.1007/s00066-016-1038-0
[10]	Eze C, Käsmann L, Manapov F. Redefining the role of prophylactic cranial irradiation in the modern era of active surveillance in small cell lung cancer[J]. JAMA Oncol, 2019, 5(1):11-12. doi: 10.1001/jamaoncol.2018.4833
[11]	Schild SE, Foster NR, Meyers JP, et al. Prophylactic cranial irradiation in small-cell lung cancer: findings from a north central cancer treatment group pooled analysis[J]. Ann Oncol, 2012, 23(11):2919-2924. doi: 10.1093/annonc/mds123
[12]	Wolfson AH, Bae K, Komaki R, et al. Primary analysis of a phase Ⅱ randomized trial radiation therapy oncology group (RTOG) 0212: impact of different total doses and schedules of prophylactic cranial irradiation on chronic neurotoxicity and quality of life for patients with limited-disease small-cell lung cancer[J]. Int J Radiat Oncol Biol Phys, 2011, 81(1):77-84. doi: 10.1016/j.ijrobp.2010.05.013
[13]	Brown PD, Pugh S, Laack NN, et al. Memantine for the prevention of cognitive dysfunction in patients receiving whole- brain radiotherapy: a randomized, double- blind, placebo- controlled trial[J]. Neuro Oncol, 2013, 15(10):1429-1437. doi: 10.1093/neuonc/not114
[14]	Jeremic B, Shibamoto Y, Nikolic N, et al. Role of radiation therapy in the combined-modality treatment of patients with extensive disease small- cell lung cancer: A randomized study[J]. J Clin Oncol, 1999, 17(7):2092-2099. doi: 10.1200/JCO.1999.17.7.2092
[15]	Slotman BJ, van Tinteren H, Praag JO, et al. Use of thoracic radiotherapy for extensive stage small- cell lung cancer: a phase 3 randomised controlled trial[J]. Lancet, 2015, 385(9962):36-42. doi: 10.1016/S0140-6736(14)61085-0
[16]	Singer L, Yom SS. Consolidative radiation therapy for extensive-stage small cell lung cancer. Transl Lung Cancer Res, 2015, 4(3):211-214. https://www.ncbi.nlm.nih.gov/pubmed/26207205
[17]	Gore EM, Hu C, Sun AY, et al. Randomized Phase Ⅱ Study Comparing Prophylactic Cranial Irradiation Alone to Prophylactic Cranial Irradiation and Consolidative Extracranial Irradiation for Extensive- Disease Small Cell Lung Cancer (ED SCLC): NRG Oncology RTOG 0937 [J]. J Thorac Oncol, 2017, 12(10):1561-1570. doi: 10.1016/j.jtho.2017.06.015
[18]	Mishra MV, Louie AV, Slotman B, et al. The evolving role of radiotherapy in the management of small cell lung cancer[J]. J Thorac Dis, 2018, 10(Suppl 21):S2545-S2554.
[19]	朱慧, 王燕, 王绿化, 等. 154例广泛期小细胞肺癌治疗结果预后因素分析[J].中华放射肿瘤学杂志, 2011, (2):96-99. http://www.wanfangdata.com.cn/details/detail.do?_type=perio&id=zhfszl201102004
[20]	栾祖鹏, 王志武, 李宝生, 等.胸部3DCRT在广泛期SCLC中的应用研究[J].中华放射肿瘤学杂志, 2014, (5):402-405. doi: 10.3760/cma.j.issn.1004-4221.2014.05.009
[21]	Luo J, Xu L, Zhao L, et al. Timing of thoracic radiotherapy in the treatment of extensive- stage small- cell lung cancer[J]. important or not, Radiat Oncol, 2017, 12(1):42. https://www.ncbi.nlm.nih.gov/pubmed/28245874
[22]	罗婧, 徐利明, 赵路军, 等.不同放化疗组合方案对广泛期SCLC预后影响[J].中华放射肿瘤学杂志, 2016, (11):1166-1171. doi: 10.3760/cma.j.issn.1004-4221.2016.11.005
[23]	Rathod S, Jeremic B, Dubey A, et al. Role of thoracic consolidation radiation in extensive stage small cell lung cancer: A systematic review and meta- analysis of randomised controlled trials[J]. J Eur J Cancer, 2019, 110:110-119. doi: 10.1016/j.ejca.2019.01.003
[24]	广泛期SCLC不同放疗分割方式疗效比较[J].中华放射肿瘤学杂志, 2015, 24(5): 488-492. http://www.wanfangdata.com.cn/details/detail.do?_type=perio&id=zhfszl201505003
[25]	Mahmoud O, Kwon D, Greenfield B, Wright JL, Samuels MA. Intrathoracic extensive-stage small cell cancer: assessment of the benefit of thoracic and brain radiotherapy using the SEER database[J]. Int J Clin Oncol, 2016, 21(6):1062-1070. doi: 10.1007/s10147-016-1011-z
[26]	Slotman BJ, Faivre-Finn C, van Tinteren H, et al. Which patients with ES-SCLC are most likely to benefit from more aggressive radiotherapy: A secondary analysis of the Phase Ⅲ CREST trial[J]. Lung Cancer, 2017, 108:150-153. doi: 10.1016/j.lungcan.2017.03.007
[27]	罗婧, 徐利明, 赵路军, 等.322例广泛期SCLC不同转移部位的生存分析[J].中华放射肿瘤学杂志, 2017, (1):17-21. doi: 10.3760/cma.j.issn.1004-4221.2017.01.004
[28]	Xu LM, Cheng C, Kang M, et al. Thoracic radiotherapy (TRT) improved survival in both oligo- and polymetastatic extensive stage small cell lung cancer[J]. Sci Rep, 2017, 7(1):9255. doi: 10.1038/s41598-017-09775-0
[29]	Lekic M, Kovac V, Triller N, Knez L, Sadikov A, Cufer T. Outcome of small cell lung cancer (SCLC) patients with brain metastases in a routine clinical setting[J]. Radiol Oncol, 2012, 46(1):54-59. http://d.old.wanfangdata.com.cn/OAPaper/oai_pubmedcentral.nih.gov_3423766
[30]	Tsao MN, Lloyd N, Wong RK, et al. Whole brain radiotherapy for the treatment of newly diagnosed multiple brain metastases[J]. Cochrane Database Syst Rev, 2012, (4):CD003869. http://d.old.wanfangdata.com.cn/OAPaper/oai_pubmedcentral.nih.gov_3431070
[31]	Sun H, Xu L, Wang P, et al. Additional radiation boost to whole brain radiation therapy may improve the survival of patients with brain metastases in small cell lung cancer[J]. J Radiat Oncol, 2018, 13(1):250. doi: 10.1186/s13014-018-1198-4