局部晚期非小细胞肺癌微小残留病灶的研究进展  

Research progress in minimal residual ddisieseaasese in in lo locacally advanced non-small cell lung cancer

作　　者：张婉婷 杨旭 惠周光 Zhang Wanting;Yang Xu;Hui Zhouguang(Department of Radiation Oncology,National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100021,China;Department of VIP Medical Services,National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100021,China)

机构地区：[1]国家癌症中心/国家肿瘤临床医学研究中心/中国医学科学院北京协和医学院肿瘤医院放疗科,北京100021 [2]国家癌症中心/国家肿瘤临床医学研究中心/中国医学科学院北京协和医学院肿瘤医院特需医疗部,北京100021

出　　处：《中华放射肿瘤学杂志》2023年第10期939-944,共6页Chinese Journal of Radiation Oncology

基　　金：首都卫生发展科研专项(2022-1-4022);中国癌症基金会北京希望马拉松专项基金(ZZ2021A02);中国医学科学院中央级公益性科研院所基本科研业务费专项资金(2022-JKCS-18);北京市希思科临床肿瘤学研究基金会(Y-HR2020ZD-0779)。

摘　　要：局部晚期不可手术非小细胞肺癌(NSCLC)的标准治疗为同步放化疗(CCRT)后巩固免疫治疗,但后续可能复发。影像学检查只能被动识别复发、无法提前预测风险,基于循环肿瘤DNA(ctDNA)检测的微小残留病灶(MRD)则成为新兴的肿瘤标志物。研究表明,ctDNA在NSCLC放(化)疗后先升后降,不仅可以预测复发,还可能指导巩固免疫治疗、评估疗效和判断预后,甚至有助于探索其他有效的治疗方案。目前将ctDNA-MRD用于指导巩固治疗相关的临床研究较少、样本量较小、证据等级较低,其临床价值仍需前瞻性随机研究进一步验证。For locally advanced unresectable non-small cell lung cancer(NSCLC),the standardregimen1is concurrent chemoradiotherapy(CCRT)followed by consolidation immunotherapy.Nevertheless,the majority of patients will experience recurrence.Traditional imaging examination has its limitations of passively identifying recurrence,unable to forecast the risk in advance.Minimal residual disease(MRD)based on circulating tumor DNA(ctDNA)has become a novel tumor biomarker.Existing studies have demonstrated that the levels of ctDNA initially increase and then decrease during CCRT for NSCLC.Monitoring ctDNA-MRD can not only robustly predict recurrence,but also guide the consolidation immunotherapy,evaluate the efficacy and predict clinical prognosis.Furthermore,ctDNA-MRD can be a reliable biomarker to explore other effective treatments.However,few ctDNA-MRD clinical studies related to guiding consolidation therapy have been performed,with small sample size and low-level evidence.The value of ctDNAMRD still needs to be confirmed by prospective randomized studies.

关 键 词：癌 非小细胞肺 放化疗法 循环肿瘤DNA 微小残留病灶 复发 巩固治疗 

分 类 号：R734.2[医药卫生—肿瘤]