PDF(Pubmed)
Abstract：
Recently, the development of targeted therapy approaches such as those based on tyrosine kinase inhibitor (TKI) greatly improved the clinical outcomes of patients affected by oncogene addicted advanced non-small cell lung cancer (NSCLC). Similarly, the improvement of radiation therapy techniques has permitted to deliver high radiation doses to a limited number of metastatic target lesions (oligopersistent or oligoprogressive), with limited high-dose normal tissue exposure that leads to low severe toxicity rates. The aim of this narrative review was to provide an overview of the currently established definition of oligometastatic and oligoprogressive disease, to define first line and subsequent lines targeted therapies and the role of consolidative non-invasive local ablative treatments (LATs) in these settings. The potential benefit of local treatment (LT) such as radiotherapy (RT) or surgery might be represented by an overall reduction of switching to subsequent systemic treatments lowering the risk of further systemic dissemination. Further randomized clinical trials will clarify the role of LT and their correct timing in relation to systemic targeted therapies.
摘要：
最近,靶向治疗方法的发展,如基于酪氨酸激酶抑制剂(TKI)的靶向治疗方法极大地改善了癌基因成瘾的晚期非小细胞肺癌(NSCLC)患者的临床结局.同样，放射治疗技术的改进允许向有限数量的转移性靶病变(少持续或少进展)提供高辐射剂量，有限的高剂量正常组织暴露导致低严重毒性率。这篇叙述性综述的目的是概述目前建立的寡转移和寡进展疾病的定义，定义一线和后续一线靶向治疗，以及在这些设置中巩固非侵入性局部消融治疗（LAT）的作用。局部治疗（LT）如放疗（RT）或手术的潜在益处可能表现为转换到随后的全身治疗的整体减少，从而降低了进一步全身传播的风险。进一步的随机临床试验将阐明LT的作用及其与全身靶向治疗相关的正确时机。
