Lung cancer, both non-small cell and small cell, harbors a high propensity for spreading to the central nervous system. Radiation therapy remains the backbone of the management of brain metastases. Recent advances in stereotactic radiosurgery have expanded its indications and ongoing studies seek to elucidate optimal fractionation and coordination with systemic therapies, especially targeted inhibitors with intracranial efficacy. Efforts in whole-brain radiotherapy aim to preserve neurocognition and to investigate the need for prophylactic cranial irradiation. As novel combinatorial strategies are tested and prognostic/predictive biomarkers are identified and tested, the management of brain metastases in lung cancer will become increasingly personalized to optimally balance intracranial efficacy with preserving neurocognitive function and patient values.
肺癌，包括非小细胞肺癌与小细胞肺癌，均具有较高的中枢神经系统转移倾向。放射治疗仍是脑转移瘤治疗的基石。立体定向放射外科技术的近期进展已拓展其适应症，当前研究正致力于阐明其最佳分割方案以及与全身性治疗（尤其是具有颅内疗效的靶向抑制剂）的协同策略。全脑放疗的研究重点在于神经认知功能保护，并探索预防性全脑照射的必要性。随着新型联合治疗策略的验证、预后/预测性生物标志物的发现与检测，肺癌脑转移的治疗将日益个体化，以期在颅内疗效、神经认知功能保护及患者价值取向之间实现最优平衡。
肿瘤(癌症)患者之家