In patients with early-stage or recurrent NSCLC who are unable to tolerate surgery, a benefit could derive only from a systemic therapy or another few forms of local therapy. A systematic review was performed to evaluate the feasibility and the effectiveness of radiotherapy combined with local ablative therapies in the treatment of primary and recurrent lung cancer in terms of toxicity profile and local control rate. Six studies featuring a total of 115 patients who met eligibility criteria and 119 lesions were included. Three studies evaluated lung cancer patients with a medically inoperable condition treated with image-guided local ablative therapies followed by radiotherapy: their local control rate (LC) ranged from 75% to 91.7% with only 15 patients (19.4%) reporting local recurrence after combined modality treatment. The other three studies provided a salvage option for patients with locally recurrent NSCLC after RT: the median follow-up period varied from 8.3 to 69.3 months with an LC rate ranging from 50% to 100%. The most common complications were radiation pneumonitis (9.5%) and pneumothorax (29.8%). The proposed intervention appears to be promising in terms of toxicity profile and local control rate. Further prospective studies are need to better delineate combining LTA-RT treatment benefits in this setting.
对于无法耐受手术的早期或复发性非小细胞肺癌患者，其临床获益可能仅来源于系统性治疗或少数局部治疗方式。本研究通过系统综述，从毒性特征和局部控制率两方面评估放疗联合局部消融治疗在原发性及复发性肺癌治疗中的可行性与有效性。共纳入六项研究，涵盖符合入选标准的115例患者及119处病灶。其中三项研究评估了因医学原因无法手术的肺癌患者接受影像引导局部消融治疗后序贯放疗的治疗效果：其局部控制率介于75%至91.7%之间，仅15例患者（19.4%）在联合治疗后出现局部复发。另外三项研究为放疗后局部复发的非小细胞肺癌患者提供了挽救治疗方案：中位随访期为8.3至69.3个月，局部控制率介于50%至100%之间。最常见的并发症为放射性肺炎（9.5%）和气胸（29.8%）。该联合治疗方案在毒性特征和局部控制率方面展现出良好前景，但需进一步开展前瞻性研究以更精确评估局部消融联合放疗在此类患者中的治疗获益。
肿瘤(癌症)患者之家