Management of oligometastatic non-small cell lung cancer patients:Current controversies and future directions  

作　　者：Felipe Counago Javier Luna Luis Leonardo Guerrero Blanca Vaquero María Cecilia Guillén-Sacoto Teresa González-Merino Begona Taboada Verónica Díaz Belén Rubio-Viqueira Ana Aurora Díaz-Gavela Francisco JoséMarcos Elia del Cerro 

机构地区：[1]Department of Radiation Oncology,Hospital Universitario Quirónsalud Madrid,Pozuelo de Alarcón,Madrid 28223,Spain [2]Department of Radiation Oncology,Hospital La Luz,Madrid 28003,Spain [3]Clinical Department,Faculty of Biomedicine,Universidad Europea,Madrid 28223,Spain [4]Department of Radiation Oncology,Hospital Fundación Jiménez Díaz,Madrid 28040,Spain [5]Department of Medical Oncology,Hospital La Luz,Madrid 28003,Spain [6]Department of Radiation Oncology,Complexo Hospitalario Universitario Santiago de Compostela,Santiago de Compostela 15706,Spain [7]Department of Radiation Oncology,Hospital Universitario Puerta del Mar,Cádiz 11009,Spain [8]Department of Medical Oncology,Hospital Universitario Quirónsalud Madrid,Pozuelo de Alarcón,Madrid 28223,Spain

出　　处：《World Journal of Clinical Oncology》2019年第10期318-339,共22页世界临床肿瘤学杂志（英文版）

摘　　要：Oligometastatic non-small cell lung cancer(NSCLC)describes an intermediate stage of NSCLC between localized and widely-disseminated disease.This stage of NSCLC is characterized by a limited number of metastases and a more indolent tumor biology.Currently,the management of oligometastatic NSCLC involves radical treatment(radiotherapy or surgery)that targets the metastatic lesions and the primary tumor to achieve disease control.This approach offers the potential to achieve prolonged survival in patients who,in the past,would have only received palliative measures.The optimal therapeutic strategies for the different scenarios of oligometastatic disease(intracranial vs extracranial disease,synchronous vs metachronous)remain undefined.Given the lack of head-to-head studies comparing radiotherapy to surgery in these patients,the decision to apply surgery or radiotherapy(with or without systemic treatment)must be based on prognostic factors that allow us to classify patients.This classification will allow us to select the most appropriate therapeutic strategy on an individualized basis.In the future,the molecular or microRNA profiles will likely improve the treatment selection process.The objective of the present article is to review the most relevant scientific evidence on the management of patients with oligometastatic NSCLC,focusing on the role of radiotherapy and surgery.We also discuss areas of controversy and future directions.Oligometastatic non-small cell lung cancer(NSCLC) describes an intermediate stage of NSCLC between localized and widely-disseminated disease.This stage of NSCLC is characterized by a limited number of metastases and a more indolent tumor biology.Currently, the management of oligometastatic NSCLC involves radical treatment(radiotherapy or surgery) that targets the metastatic lesions and the primary tumor to achieve disease control.This approach offers the potential to achieve prolonged survival in patients who, in the past, would have only received palliative measures.The optimal therapeutic strategies for the different scenarios of oligometastatic disease(intracranial vs extracranial disease,synchronous vs metachronous) remain undefined.Given the lack of head-to-head studies comparing radiotherapy to surgery in these patients, the decision to apply surgery or radiotherapy(with or without systemic treatment) must be based on prognostic factors that allow us to classify patients.This classification will allow us to select the most appropriate therapeutic strategy on an individualized basis.In the future, the molecular or microRNA profiles will likely improve the treatment selection process.The objective of the present article is to review the most relevant scientific evidence on the management of patients with oligometastatic NSCLC, focusing on the role of radiotherapy and surgery.We also discuss areas of controversy and future directions.

关 键 词：NON-SMALL cell lung cancer METASTASECTOMY OLIGOMETASTASES STEREOTACTIC ablative radiotherapy STEREOTACTIC body radiation therapy RADIOSURGERY 

分 类 号：R[医药卫生]