Abstract：
Surgery is the standard treatment for operable patients with stage I non-small cell lung cancer (NSCLC) (T1-T2aN0M0). Stereotactic body radiotherapy (SBRT) is the treatment of choice for non-operable patients, and its positioning for operable patients remains to be clarified. The pattern of recurrence after management of stage I NSCLC is dominated by the risk of distant recurrence, this constituting the rationale for the adjunction of systemic treatment, and especially check point inhibitor (CPI), in combination with surgery or SBRT for patients with high risk features. While the benefit of postoperative CPI on the micro-metastatic disease is logically considered within the framework of a simply additive effect of both therapeutic modalities, it is reasonable to consider a synergistic effect of both CPI and SBRT. Given the role of tumor draining nodes in the development of an anti-tumor immune response, a \"tumor-draining node sparing\" strategy enabled by SBRT could therefore be of major interest in combination with CPI. Pending confirmation of the role of CPI in combination with RTS for the management of stage I NSCLC, we thus discuss in this review the theoretical advantages that this therapeutic strategy could have compared to a surgical strategy.
摘要：
手术是I期非小细胞肺癌（NSCLC）（T1-T2aN0M0）可手术患者的标准治疗方法。立体定向放射治疗（SBRT）是不可手术患者的首选治疗方法，其对可手术患者的定位仍有待澄清。治疗I期非小细胞肺癌后的复发模式主要是远处复发的风险。这构成了系统治疗的基本原理，尤其是检查点抑制剂(CPI)，结合手术或SBRT治疗具有高风险特征的患者。尽管在两种治疗方式的简单累加效应的框架内，从逻辑上考虑了术后CPI对微转移性疾病的益处。考虑CPI和SBRT的协同效应是合理的。鉴于肿瘤引流节点在抗肿瘤免疫反应发展中的作用，因此，SBRT启用的“肿瘤引流节点保留”策略可能与CPI结合使用。在确认CPI与RTS联合治疗I期NSCLC的作用之前，因此,我们在这篇综述中讨论了这种治疗策略与手术策略相比可能具有的理论优势.
