放疗联合免疫治疗非小细胞肺癌:前沿学术问题专家交流共识  

Combination of Radiation Therapy and Immunotherapy for Non-small Cell Lung Cancer:Peer Exchange on Frontier Academic Topics

作　　者：无 艾星浩[2] 蔡勇[3] 褚倩[4] 韩琤波[5] 卢铀[6] 秦颂兵[7] 邬麟[8] 谢丛华[9] 袁智勇[10] 钟文昭[11] 朱晓霞[12] 张玉蛟 朱正飞 无;Xinghao AI;Yong CAI;Qian CHU;Chengbo HAN;You LU;Songbing QIN;Lin WU;Conghua XIE;Zhiyong YUAN;Wenzhao ZHONG;Xiaoxia ZHU;Joe Y.CHANG;Zhengfei ZHU(Radiotherapy-Immunotherapy Discussion Group;Lung Tumor Clinical Medical Center,Shanghai Chest Hospital,Shanghai Jiao Tong University,Shanghai 200030,China;De-partment of Radiation Oncology,Shanghai Pulmonary Hospital,Tongji University School of Medicine,Shanghai 200433,China;Department of Radiation Oncology,Tongji Hospital,Tongji Medical College,Wuhan 430030,China;Department of Clinical Oncology,Shengjing Hospital,China Medical University,Shenyang 110022,China;Department of Oncology,West China Hos-pital,Sichuan University,Chengdu 610041,China;Department of Radiation Oncology,The First Affiliated Hospital of Suzhou University,Suzhou 215006,China;Hunan Cancer Hospital The Affiliated Cancer Hospital of Xiangya School of Medicine,Cen-tral South University,Changsha 410013,China;Department of Cancer Radiotherapy and Chemotherapy,Zhongnan Hospital of Wuhan University,Wuhan 430071,China;Department of Radiation Oncology,Cancer Institute and Hospital,Tianjin Medical University,Tianjin 300060,China;Cancer Center,Guangdong General Hospital,Guangdong Academy of Medical Sciences,Guangdong Lung Cancer Institute,Guangzhou 510080,China;Department of Radiation Oncology,Nanfang Hospital,Southern Medical University,Guangzhou 510515,China;Department of Radiation Oncology,The University of Texas MD Anderson Cancer Center,Houston TX 77030,USA;Department of Radiotherapy,Fudan University Shanghai Cancer Center,Shanghai 200032,China)

机构地区：[1]放射肿瘤学免疫联合治疗专家讨论小组 [2]上海交通大学医学院上海市胸科医院肺部肿瘤临床医学中心,上海200030 [3]同济大学附属上海市肺科医院放疗科,上海200433 [4]华中科技大学同济医学院附属同济医院,武汉430030 [5]中国医科大学附属盛京医院肿瘤科,沈阳110022 [6]四川大学华西医院肿瘤科,成都610041 [7]苏州大学附属第一医院放疗科,苏州215006 [8]中南大学湘雅医学院附属湖南省肿瘤医院,长沙410013 [9]武汉大学中南医院肿瘤放化疗科,武汉430071 [10]天津医科大学肿瘤医院放疗科,天津300060 [11]广东省肺癌研究所广东省人民医院广东省医学科学院,广州510080 [12]南方医科大学南方医院放疗科,广州510515 [13]德克萨斯大学MD Anderson肿瘤中心放疗科,休斯顿TX77030 [14]复旦大学附属肿瘤医院放疗科,上海200032

出　　处：《中国肺癌杂志》2020年第6期532-540,共9页Chinese Journal of Lung Cancer

摘　　要：肺癌是目前导致全球和中国癌症患者死亡的主要瘤种。多年来,常规的肿瘤治疗方法,如手术、化疗和放疗一直主导着非小细胞肺癌(non-small cell lung cancer,NSCLC)治疗领域。临床实践中引入免疫疗法使肺癌的治疗与其他实体瘤一样发生了根本性转变。最新临床前和临床数据表明,放疗可以通过诱导免疫原性细胞死亡和重新编程肿瘤微环境促进抗肿瘤免疫反应。研究者开始重新审视放疗作为免疫治疗的联合疗法,导致研究其潜在协同作用的临床试验数量呈指数级增长。放疗联合免疫治疗的临床试验引起了医疗界的广泛关注,会议邀请专家交流前沿及争议学术问题:①放疗联合免疫检查点抑制剂治疗NSCLC最新进展;②放疗联合免疫治疗是否显著增加毒性;③免疫检查点抑制剂治疗后出现的混合反应及局部治疗的干预价值;④放疗联合免疫治疗脑转移瘤的机制和进展。Lung cancer is the leading cause of cancer death worldwide as well as in China.For many years,conven-tional oncologic treatments such as surgery,chemotherapy,and radiotherapy(RT)have dominated the field of non-small cell lung cancer(NSCLC).The recent introduction of immunotherapy in clinical practice,led to a paradigm shift in lung cancer as in many other solid tumors.Recent pre-clinical and clinical data have shown RT may also modify antitumor immune responses through induction of immunogenic cell death and reprogramming of the tumor microenvironment.This has led many to re-examine RT as a partner therapy to immuno-oncology treatments and investigate their potential synergy in an exponentially growing number of clinical trials.Clinical trials combining radiotherapy and immunotherapy are attracting major attention,ex-perts were invited to discuss frontier and controversial academic topics:(1)Recent developments of clinical synergy between radiation and immune checkpoint inhibitors(ICIs)in the treatment of NSCLC;(2)Will immunotherapy and radiotherapy increase the toxicity risk for cancer patients;(3)How to cope the mixed responses/disassociated responses phenomenon in checkpoint inhibition therapy to NSCLC with local ablative therapy;(4)Combining radiotherapy and immunotherapy in the treatment of NSCLC brain metastases.

关 键 词：免疫检查点抑制剂 肿瘤 放疗 免疫治疗 不良反应 毒性 混合反应 脑转移 

分 类 号：R734.2[医药卫生—肿瘤]