早期肺癌的新诊断和非手术局部治疗方法

IF 4.5 2区 医学 Q1 ONCOLOGY
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引用次数: 0

摘要

本文重点介绍了改变早期肺癌治疗方法的诊断和非手术局部治疗模式的发展。这些创新旨在提高诊断的准确性,最大限度地减少侵入性,并改善患者的预后。液体活检是一种很有前景的无创诊断和监测工具,它可以在尚未标准化以及尚未纳入指南的情况下实现早期干预。支气管内导航已成为一种创新工具。在非手术治疗方面,立体定向体放射治疗(SBRT)作为早期肺癌的一种非侵入性局部治疗方式继续大放异彩,是指南推荐的无法手术患者和拒绝手术切除风险患者的标准治疗方法。由于其毒性低、局部控制效果好,即使对体质较好的患者来说,它也是一种有吸引力的手术替代疗法。利用微波或脉冲场电穿孔等能量的经皮消融技术是不适合手术或 SBRT 的患者的选择。支气管镜消融术可提供相同的能量,但气胸发生率非常低,因此也适用于多发性和双侧病变的患者。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
New diagnostic and nonsurgical local treatment modalities for early stage lung cancer

This paper highlights developments in diagnostic and nonsurgical local treatment modalities that have changed the management of early-stage lung cancer. These innovations aim to enhance diagnostic accuracy, minimize invasiveness, and improve patient outcomes.

Liquid biopsies are emerging as promising tools for non-invasive diagnosis and monitoring, enabling earlier intervention without being standardized yet as well as not yet anchored in the guidelines. Endobronchial navigation has emerged as an innovative tool. By combining electromagnetic or GPS-like technology with 3D imaging and a steerable catheter, it enables accurate biopsy of small, peripheral lesions that were once challenging to sample, with a very low pneumothorax rate.

Regarding nonsurgical treatments, stereotactic body radiotherapy (SBRT) continues to shine as a non-invasive local treatment modality for early-stage lung cancer and is the guideline-recommended standard-of-care for inoperable patients and patients refusing the risk of surgical resection. The low toxicity and excellent local control has made it an attractive alternative to surgery even in fitter patients. Percutaneous ablative techniques utilising energies such as microwave or pulse-field electroporation are options for patients who are not candidates for surgery or SBRT. Bronchoscopic ablation delivers the same energies but with a very lower pneumothorax rate and it is therefore also open to patients with multiple and bilateral lesions.

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来源期刊
Lung Cancer
Lung Cancer 医学-呼吸系统
CiteScore
9.40
自引率
3.80%
发文量
407
审稿时长
25 days
期刊介绍: Lung Cancer is an international publication covering the clinical, translational and basic science of malignancies of the lung and chest region.Original research articles, early reports, review articles, editorials and correspondence covering the prevention, epidemiology and etiology, basic biology, pathology, clinical assessment, surgery, chemotherapy, radiotherapy, combined treatment modalities, other treatment modalities and outcomes of lung cancer are welcome.
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