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

World Journal of Clinical Oncology 2019年第10期10卷 318-339页

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 Department of Radiation Oncology Hospital Universitario Quirónsalud MadridPozuelo de AlarcónMadrid 28223Spain Department of Radiation Oncology Hospital La LuzMadrid 28003Spain Clinical Department Faculty of BiomedicineUniversidad EuropeaMadrid 28223Spain Department of Radiation Oncology Hospital Fundación Jiménez DíazMadrid 28040Spain Department of Medical Oncology Hospital La LuzMadrid 28003Spain Department of Radiation Oncology Complexo Hospitalario Universitario Santiago de CompostelaSantiago de Compostela 15706Spain Department of Radiation Oncology Hospital Universitario Puerta del MarCádiz 11009Spain Department of Medical Oncology Hospital Universitario Quirónsalud MadridPozuelo de AlarcónMadrid 28223Spain

Oligometastatic non-small cell lung cancer(NSCLC)describes an intermediate stage of NSCLC between localized and widely-disseminated *** stage of NSCLC is characterized by a limited number of metastases and a more indolent tumor ***,the management of oligometastatic NSCLC involves radical treatment(radiotherapy or surgery)that targets the metastatic lesions and the primary tumor to achieve disease *** approach offers the potential to achieve prolonged survival in patients who,in the past,would have only received palliative *** optimal therapeutic strategies for the different scenarios of oligometastatic disease(intracranial vs extracranial disease,synchronous vs metachronous)remain *** 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 *** classification will allow us to select the most appropriate therapeutic strategy on an individualized *** the future,the molecular or microRNA profiles will likely improve the treatment selection *** 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 *** 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

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