Modern Radiation Therapy for the Management of Brain Metastases From Non-Small Cell Lung Cancer: Current Approaches and Future Directions.
Modern Radiation Therapy for the Management of Brain Metastases From Non-Small Cell Lung Cancer: Current Approaches and Future Directions.
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DOI：
10.3389/fonc.2021.772789
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发表时间：
2021
影响因子：
4.7
通讯作者：
Levis M
中科院分区：
文献类型：
--
作者：
Mantovani C;Gastino A;Cerrato M;Badellino S;Ricardi U;Levis M
脑转移（BM）是非小细胞肺癌（NSCLC）病程中最常见的事件。诊断和治疗程序的最新进展导致BM的发病率增加和早期诊断，需要通过采用定制的治疗方案来优化这些患者的预后。如今，个性化和多学科的方法应该依赖于几个临床和分子因素，如患者的表现状态，脑受累的程度和位置，颅外疾病控制和任何“可药物化”分子靶点的存在。放射治疗（RT），在其所有的局灶性（放射外科和分次立体定向放射治疗）或扩展（全脑放射治疗）的下降，是BM管理的基石，无论是单独或与手术和全身治疗相结合。我们的审查旨在提供一个概述的许多现代RT解决方案可用于治疗BM从NSCLC在不同的临床情况下（单病灶，寡和多转移，软脑膜癌病）。这包括详细审查每种情况下的现行标准治疗，介绍文献数据和可能的技术解决方案，为这些患者提供“最先进”的治疗。除了经过验证的治疗方案外，我们还将讨论新兴RT技术策略的未来前景（例如，海马回避全脑RT，同时整合加强，多个病变的放射外科手术），并提出了创新和有前途的发现，关于新的靶向药物，如酪氨酸激酶抑制剂和免疫检查点抑制剂与脑照射的组合。
Brain metastases (BMs) represent the most frequent event during the course of Non-Small Cell Lung Cancer (NSCLC) disease. Recent advancements in the diagnostic and therapeutic procedures result in increased incidence and earlier diagnosis of BMs, with an emerging need to optimize the prognosis of these patients through the adoption of tailored treatment solutions. Nowadays a personalized and multidisciplinary approach should rely on several clinical and molecular factors like patient’s performance status, extent and location of brain involvement, extracranial disease control and the presence of any “druggable” molecular target. Radiation therapy (RT), in all its focal (radiosurgery and fractionated stereotactic radiotherapy) or extended (whole brain radiotherapy) declinations, is a cornerstone of BMs management, either alone or combined with surgery and systemic therapies. Our review aims to provide an overview of the many modern RT solutions available for the treatment of BMs from NSCLC in the different clinical scenarios (single lesion, oligo and poly-metastasis, leptomeningeal carcinomatosis). This includes a detailed review of the current standard of care in each setting, with a presentation of the literature data and of the possible technical solutions to offer a “state-of-art” treatment to these patients. In addition to the validated treatment options, we will also discuss the future perspectives on emerging RT technical strategies (e.g., hippocampal avoidance whole brain RT, simultaneous integrated boost, radiosurgery for multiple lesions), and present the innovative and promising findings regarding the combination of novel targeted agents such as tyrosine kinase inhibitors and immune checkpoint inhibitors with brain irradiation.
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影响因子：
3.8
作者：
Chia BSH;Leong JY;Ong ALK;Lim C;Poon SH;Chua MLK;Chua KLM;Kusumawidjaja G;Chua ET;Wong FY;Lee TS
通讯作者：
Lee TS
影响因子：
120.7
作者：
Aoyama, Hidefumi;Shirato, Hiroki;Kobashi, Gen
通讯作者：
Kobashi, Gen
影响因子：
3.8
作者：
Chen, Yanxin;Wei, Jianping;Liu, Anwen
通讯作者：
Liu, Anwen
影响因子：
5.2
作者：
Cho A;Untersteiner H;Hirschmann D;Shaltout A;Göbl P;Dorfer C;Rössler K;Marik W;Kirchbacher K;Kapfhammer I;Zöchbauer-Müller S;Gatterbauer B;Hochmair MJ;Frischer JM
通讯作者：
Frischer JM
DOI：
10.1016/j.ijrobp.2013.07.034
发表时间：
2013-11-15
影响因子：
7
作者：
Atalar, Banu;Modlin, Leslie A.;Soltys, Scott G.
通讯作者：
Soltys, Scott G.