Under the era of immuno-targeted treatment of lung cancer, the status of radiotherapy cornerstone is difficult to shake, and precision radiotherapy is becoming more and more important.

The annual meeting of the Professional Committee of Lung Cancer of the Beijing Cancer Society was held in Beijing on the theme of "The Field of Immunotargeted Treatment and Comprehensive Treatment of Lung Cancer".
invited one of the Presidents of the Conference, Professor Wang Greening of Shenzhen Hospital of the Chinese Academy of Medical Sciences, to conduct an exclusive interview on the highlights of the meeting, lung cancer target immunotherapy era of decentralized therapy role and development direction, such as in-depth interpretation.
Wang Greening, Director Physician Doctoral Mentor, Special Grant Specialist of the State Council, President of The Chinese Academy of Medical Sciences Cancer Hospital Shenzhen Hospital, Chairman of the Chinese Medical Association's Radiocancer Credit Committee, Deputy Director of the Chinese Society of Clinical Oncology (CSCO), Deputy Director of the Radiotherapy Professional Committee of the Chinese Association of Cancer, Executive Deputy Director of the National Center for Standardization of Cancer Diagnosis and Treatment, Deputy Director of the National Cancer Center, Andain-China Radiotherapy Committee Multidisciplinary participation, new progress in a timely exchange Of this conference is an online combination of offline form, to explore the progress of lung cancer research academic activities.
lung cancer is the most active field of cancer research at present, the treatment has made a lot of progress, our original intention is through academic exchanges, on the one hand, knowledge update, on the other hand, to help for more standardized clinical treatment.
lung cancer requires multidisciplinary involvement in comprehensive treatment, and more and more specialists in disciplines are now involved, including internal medicine, surgery, radiotherapy, imaging and molecular pathology.
, for example, screening for lung cancer patients, from previously simple X-rays, CTs, bone scans to the increasingly popular PET-CT.
and pathological diagnosis, previously only need to distinguish between small cell lung cancer and non-small cell lung cancer (NSCLC), now in addition to refining specific pathological subtypes, but also to identify genetic mutations and immunotherapy-related indicators, including PD-L1 immunohiscification, clear tumor ratio score (TPS), joint scoring positive (CPS) and so on.
the development of these technologies is to accurately treat, so that treatment more personalized, standardized, but also more efficient.
this meeting is a high-level meeting of internal medicine, surgery, radiotherapy, imaging and molecular pathologists, which has played a very good role in meeting the urgent need for academic exchanges.
the era of immuno-targeted treatment, the position of precision radiotherapy of lung cancer is becoming increasingly important Although the new target and immunotherapy research progress is very active, but the three cornerstones of traditional treatment remain unchanged: surgical treatment is the preferred treatment of early lung cancer, radiation therapy is the main treatment of local advanced lung cancer, chemotherapy in various stages of lung cancer has a very important role, including early lung cancer postoperative complementary chemotherapy, local advanced lung cancer synchronous chemotherapy and advanced lung cancer.
we should be vigilant and avoid blind use of targeted and immunotherapy regardless of patient situation.
in the new treatment mode, radiation therapy still plays a very important role in the treatment of lung cancer.
stereotactic radiation therapy for patients with early NSCLC who cannot be operated on, which can achieve a cure rate comparable to surgery, and provide a new treatment for patients with early lung cancer.
simultaneous chemotherapy is the standard treatment for local advanced lung cancer, and standard treatment is also exploring new treatment models.
a recent real-world study of more than 400 patients shows that for patients with local advanced lung cancer with driven genetic mutations, the efficacy of combined radiation-targeted therapy is better than synchrotron chemotherapy and simple targeted therapy, which provides a new way of thinking for future clinical studies, and we need to study the advantages and disadvantages of synchronous chemotherapy and syncyathyre-targeted treatment.
the status of radiotherapy is more important than ever for the treatment of advanced NSCLC.
isolated brain metastasis can be surgically removed, or X-knife, gamma knife, stereotactic radiation therapy, while late-stage patients may be more prone to noninvasive treatment.
for the oligometamorphic lesions of 3 to 5 transfer stoves, stereotactic radiation therapy is a conventional treatment mode.
and for extensive brain metastasis and meninges transfer, radiation therapy also plays a major therapeutic role, for driving gene-positive patients, radiotherapy combined targeted therapy can further improve local control and survival rate, increase clinical benefits.
for extracranial metastatic lesions, the same can be further extended by local treatment of progressionless survival and total survival, and on bone metastasis and pulmonary primary lesions radiation to help further reduce clinical symptoms, so that local lesions get good control, improve the quality of life of patients.
in the age of immunotherapy, for non-removable local late-stage NSCLC patients, the simultaneous chemotherapy after the line of valprosue monoimmune maintenance therapy for the improvement of survival rate to bring a breakthrough.
over the past decade, the exploration of other therapies based on synchronous chemotherapy has not been able to further improve the efficacy, such as pre-induced chemotherapy and then synchronous chemotherapy, and synchronous chemotherapy compared to no advantage, and the study of consolidation chemotherapy after simultaneous chemotherapy is also negative results.
now THE PACIFIC STUDY has found a new way that immunosustained therapy after simultaneous chemotherapy can further improve patient symmy and survival, and the definitive clinical evidence confirms that immunosustained therapy can benefit from simultaneous chemotherapy.
the relationship between radiotherapy and immunotherapy, it is generally believed that radiotherapy can improve the effect of immunotherapy through antigen presentation and immunomodulation. In
late NSCLC, the patterns of radiotherapy combination immunotherapy, radiotherapy combined chemotherapy and immunotherapy are being explored.
therefore, in the new treatment situation, radiotherapy needs to be proactive and internal medicine, molecular pathology and other cooperation, do a good job in clinical and transformational research work, so that patients get better efficacy.
therefore, in the age of lung cancer immuno-targeted treatment, the role of radiotherapy is strengthened.
the future development direction of radiotherapy combined immunotherapy first, for non-removable local late-stage NSCLC, synchrotron chemotherapy combined immunotherapy is the best treatment mode at present.
but the domestic recognition of synchronous chemotherapy and the proportion of use is not high, if not synchronized chemotherapy, immunosustained treatment may be affected.
, therefore, it is necessary to promote standardized treatment, increase the proportion of simultaneous chemotherapy application, so as to improve the non-removable local late-stage NSCLC therapeutic efficacy.
second, some patients who are not suitable for simultaneous chemotherapy need sequential chemotherapy, immunotherapy era for such patients radiation model should also be further studied, including dose segmentation, course of treatment, total dose, etc., are needed to explore the content.
third, now many domestic radiotherapy centers use three-dimensional shape-sensitive radiotherapy technology, image-guided radiotherapy technology and other international latest technology, these technologies on tumor killing more accurate, the protection of normal tissue is better, so now radiotherapy has better efficacy and safety.
in general, radiotherapy benefits outweigh the disadvantages, adverse reactions are under control, so patients should be called to face the disease rationally, scientific selection of the best treatment mode.
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