局限期小细胞肺癌放射治疗研究进展  

Radiotherapy advances of limited-stage small cell lung cancer

作　　者：张晴 屈艳丽 刘航宇 于洪 Zhang Qing;Qu Yanli;Liu Hangyu;Yu Hong(Radiation Oncology Department of Thoracic Cancer,Cancer Hospital of China Medical University,Liaoning Gancer Hospital & Institute,Liaoning Shenyang 110042,China)

机构地区：[1]中国医科大学肿瘤医院,辽宁省肿瘤医院胸部放疗科,辽宁沈阳110042

出　　处：《现代肿瘤医学》2019年第6期1068-1072,共5页Journal of Modern Oncology

基　　金：辽宁省自然科学基金资助项目(编号:2015020263)

摘　　要：小细胞肺癌(small cell lung cancer,SCLC)是高度恶性肿瘤,生物学特点是倍增时间短、增殖指数高和侵袭能力强。尽管对化放疗高度敏感,但极易耐药和复发,预后很差。确诊时约1/3属于局限期(limited-stage,LS)。LS-SCLC具有潜在治愈的可能,采用以铂类为基础的化疗联合胸部放疗,长期生存率达20%～25%。初治达完全或部分缓解的LS-SCLC患者行预防性脑照射(prophylactic cranial irradiation,PCI)可降低脑转移发生率,改善生活质量。随着SCLC患者生存期延长,局部治疗变得非常重要,如何最大程度地降低局部复发的危险性一直是临床研究热点。本文中我们分析了LS-SCLC放射治疗的研究现状,探索最佳放射剂量、次数、靶区、时机及PCI。Small cell lung cancer (SCLC) is a very aggressive malignancy characterized by rapid doubling time,high cellular proliferation and early metastatic spread.In fact,although SCLC is a chemosensitive and radiosensitive disease,the initial responsiveness to chemotherapy is usually followed by development of resistance and the prognosis remains poor.At the time of diagnosis,about a third of the patients are in the limited-stage (LS).LS-SCLC is a potentially curable disease with long-term survival of 20% to 25% when treated with platinum-based chemotherapy plus concurrent thoracic radiation.Prophylactic cranial irradiation (PCI) may decrease the incidence of brain metastases in patients with LS-SCLC and improve survival in patients achieving complete or partial remission after initial treatment.As the survival time of SCLC patients is prolonged,local treatment becomes very important.For all these reasons,how to reduce the risk of local recurrence has always been a hot topic in clinical research.In this review,we analyzed the current situation of radiation therapy for LS-SCLC,to explore the optimal PCI,timing,target volume,fraction and dose of radiotherapy.

关 键 词：小细胞肺癌 局限期 治疗 胸部放疗 预防性脑照射 

分 类 号：R734.2[医药卫生—肿瘤]