|本期目录/Table of Contents|

[1]蔡猛,周光新.非小细胞肺癌骨转移的治疗研究进展[J].医学研究与战创伤救治(原医学研究生学报),2022,24(4):408-413.[doi:10.3969/j.issn.1672-271X.2022.04.015]
　CAI Meng,ZHOU Guang-xin.Research progress in the treatment of bone metastasis in non-small cell lung cancer[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2022,24(4):408-413.[doi:10.3969/j.issn.1672-271X.2022.04.015]
点击复制

非小细胞肺癌骨转移的治疗研究进展()
分享到62.8K

《医学研究与战创伤救治》（原医学研究生学报）[ISSN:1672-271X/CN:32-1713/R]

卷:
第24卷
期数:
2022年4期
页码:
408-413
栏目:
综述
出版日期:
2022-08-30

文章信息/Info

Title:
Research progress in the treatment of bone metastasis in non-small cell lung cancer
作者:
蔡猛; 周光新
作者单位：210002南京，东部战区总医院（原南京军区南京总医院）骨科(蔡猛、周光新)
Author(s):
CAI Meng ;  ZHOU Guang-xin
(Department of Orthopedics, General Hospital of Eastern Theater Command, PLA, Nanjing 210002, Jiangsu, China)
关键词:
非小细胞肺癌; 手术; 放疗; 化疗
Keywords:
non-small cell lung cancer;  surgery;  radiotherapy; chemotherapy
分类号:
R738.1
DOI:
10.3969/j.issn.1672-271X.2022.04.015
文献标志码:
A
摘要:
远处转移被认为是非小细胞肺癌(NSCLC)患者死亡的主要原因之一， 患者往往在被诊断为NSCLC时就已经发生转移。 常见的转移部位包括骨、 脑、 肝和淋巴， 其中又以骨转移最为常见。骨转移是NSCLC患者预后差、死亡率高的主要原因之一。此外， 骨转移通常会引起骨相关事件(SRE)的发生， 如病理性骨折、脊髓压迫、 脊柱不稳等。这些SRE往往导致患者的生活质量下降、 医疗费用增加和生存期缩短。骨转移的治疗目前采取手术、放化疗、靶向治疗、免疫抑制剂治疗、双膦酸盐等治疗方案。尽管近年来临床上的治疗策略取得了一定进展， 但由于 NSCLC缺乏典型症状导致的晚期诊断和较高的远处转移率，目前患者的预后仍旧较差。文章主要就近年来手术、放化疗、靶向治疗、免疫抑制剂治疗等对NSCLC骨转移的治疗进展进行综述。
Abstract:
Distant metastasis is considered to be one of the main causes of death in patients with non-small cell lung cancer (NSCLC), and patients often have metastases when they are diagnosed with NSCLC. Common sites of metastasis include bone, brain, liver and lymph, among which bone metastasis is the preferred. Bone metastasis is one of the main reasons for the poor prognosis and high mortality of NSCLC patients. In addition, bone metastases usually cause the occurrence of skeletal related event (SRE), such as pathological fractures, spinal cord compression, and spinal instability. These SREs often lead to reduced patient quality of life, increase healthcare costs, and shorten survival. The current treatment options for bone metastases include surgery, radiotherapy and chemotherapy, targeted therapy, immunosuppressive therapy, and bisphosphonates. Although some progress has been made in clinical treatment strategies in recent years, the prognosis of patients with NSCLC is still poor due to the late diagnosis and high rate of distant metastasis caused by the lack of typical symptoms of NSCLC. This manuscript mainly reviews the recent progress in the treatment of NSCLC bone metastases by surgery, radiotherapy and chemotherapy, targeted therapy, and immunosuppressive therapy.

参考文献/References:

[1]Brouns A, Dursun S, Bootsma G, et al. Reporting of Incidence and Outcome of Bone Metastases in Clinical Trials Enrolling Patients with Epidermal Growth Factor Receptor Mutated Lung Adenocarcinoma-A Systematic Review[J]. Cancers(Basel), 2021,13(13):3144.
[2]Kuchuk M, Addison CL, Clemons M, et al. Incidence and consequences of bone metastases in lung cancer patients[J]. J Bone Oncol,2013,2(1):22-29.
[3]She K, Yang W, Li M, et al. FAIM2 Promotes Non-Small Cell Lung Cancer Cell Growth and Bone Metastasis by Activating the Wnt/β-Catenin Pathway[J]. Front Oncol, 2021,11:690142.
[4]Broder MS, Gutierrez B, Cherepanov D, et al. Burden of skeletal-related events in prostate cancer: unmet need in pain improvement[J]. Support Care Cancer, 2015,23(1):237-247.
[5]Wood DE, Kazerooni EA, Baum SL, et al. Lung Cancer Screening, Version 3.2018, NCCN Clinical Practice Guidelines in Oncology[J]. J Natl Compr Canc Netw, 2018,16(4):412-441.
[6]Juan O, Popat S. Ablative Therapy for Oligometastatic Non-Small Cell Lung Cancer[J]. Clin Lung Cancer, 2017,18(6):595-606.
[7]Sun Z, Sui X, Yang F, et al. Effects of primary tumor resection on the survival of patients with stage IV extrathoracic metastatic non-small cell lung cancer: A population-based study[J]. Lung Cancer, 2019,129:98-106.
[8]Congedo MT, Nachira D, Bertolaccini L, et al. Multimodal therapy for synchronous bone oligometastatic NSCLC: The role of surgery[J]. J Surg Oncol, 2022,125(4):782-789.
[9]Abdel-Rahman O. Outcomes of Surgery as Part of the Management of Metastatic Non-Small-Cell Lung Cancer: A Surveillance, Epidemiology and End Results Database Analysis[J]. Cancer Invest, 2018,36(4):238-245.
[10]Zhu S, Ge T, Hu J, et al. Prognostic value of surgical intervention in advanced lung adenocarcinoma: a population-based study[J]. J Thorac Dis, 2021,13(10):5942-5953.
[11]Hasselle MD, Haraf DJ, Rusthoven KE, et al. Hypofractionated image-guided radiation therapy for patients with limited volume metastatic non-small cell lung cancer[J]. J Thorac Oncol, 2012,7(2):376-381.
[12]Stavas MJ, Arneson KO, Ning MS, et al. The Refusal of Palliative Radiation in Metastatic Non-Small Cell Lung Cancer and Its Prognostic Implications[J]. J Pain Symptom Manage, 2015,49(6):1081-1087.e4.
[13]Lopez Guerra JL, Gomez D, Zhuang Y, et al. Prognostic impact of radiation therapy to the primary tumor in patients with non-small cell lung cancer and oligometastasis at diagnosis[J]. Int J Radiat Oncol Biol Phys, 2012,84(1):e61-e67.
[14]Kong P, Yan J, Liu D, et al. Skeletal-related events and overall survival of patients with bone metastasis from nonsmall cell lung cancer - A retrospective analysis[J]. Medicine(Baltimore), 2017,96(51):e9327.
[15]Grossi F, Kubota K, Cappuzzo F, et al. Future scenarios for the treatment of advanced non-small cell lung cancer: focus on taxane-containing regimens[J]. Oncologist, 2010,15(10):1102-1112.
[16]Shi S, Wang H, Liu X, et al. Prediction of overall survival of non-small cell lung cancer with bone metastasis: an analysis of the Surveillance, Epidemiology and End Results(SEER) database[J]. Transl Cancer Res, 2021,10(12):5191-5203.
[17]Xiao C, Yang X, Hao J, et al. Clinicopathological features and prognostic analysis of metastatic pulmonary sarcomatoid carcinoma: a SEER analysis[J]. J Thorac Dis, 2021,13(2):893-905.
[18]Jung JM, Hyun SJ, Kim KJ. Surgical Impacts of Metastatic Non-small Cell Lung Cancer to the Thoracic and Lumbar Spine[J]. J Korean Med Sci, 2021,36(7):e52.
[19]Meng C, Ge X, Tian J, et al. Prognostic role of targeted therapy in patients with multiple-site metastases from non-small- cell lung cancer[J]. Future Oncol, 2020,16(26):1957-1967.
[20]Wakeling AE, Guy SP, Woodburn JR, et al. ZD1839(Iressa): an orally active inhibitor of epidermal growth factor signaling with potential for cancer therapy[J]. Cancer Res, 2002,62(20):5749-5754.
[21]Tiseo M, Rossi G, Capelletti M, et al. Predictors of gefitinib outcomes in advanced non-small cell lung cancer(NSCLC): study of a comprehensive panel of molecular markers[J]. Lung Cancer, 2010,67(3):355-360.
[22]Sugiura H, Yamada K, Sugiura T, et al. Predictors of survival in patients with bone metastasis of lung cancer[J]. Clin Orthop Relat Res, 2008,466(3):729-736.
[23]Bae HM, Lee SH, Kim TM, et al. Prognostic factors for non-small cell lung cancer with bone metastasis at the time of diagnosis[J]. Lung Cancer, 2012,77(3):572-577.
[24]Furugaki K, Moriya Y, Iwai T, et al. Erlotinib inhibits osteolytic bone invasion of human non-small-cell lung cancer cell line NCI-H292[J]. Clin Exp Metastasis, 2011,28(7):649-659.
[25]Gabr AG, Goto H, Hanibuchi M, et al. Erlotinib prevents experimental metastases of human small cell lung cancer cells with no epidermal growth factor receptor expression[J]. Clin Exp Metastasis, 2012,29(3):207-216.
[26]Liang F, Zhang S, Wang Q, et al. Clinical benefit of immune checkpoint inhibitors approved by US Food and Drug Administration[J]. BMC Cancer, 2020,20(1):823.
[27]Mamdani H, Matosevic S, Khalid AB, et al. Immunotherapy in Lung Cancer: Current Landscape and Future Directions[J]. Front Immunol, 2022,13:823618.
[28]Ettinger DS, Wood DE, Aisner DL, et al. NCCN Guidelines Insights: Non-Small Cell Lung Cancer, Version 2.2021[J]. J Natl Compr Canc Netw, 2021,19(3):254-266.
[29]Zhang G, Cheng R, Wang H, et al. Comparable outcomes of nivolumab in patients with advanced NSCLC presenting with or without brain metastases: a retrospective cohort study[J]. Cancer Immunol Immunother, 2020,69(3):399-405.
[30]Schmid S, Diem S, Li Q, et al. Organ-specific response to nivolumab in patients with non-small cell lung cancer(NSCLC) [J]. Cancer Immunol Immunother, 2018,67(12):1825-1832.
[31]Tamiya M, Tamiya A, Inoue T, et al. Metastatic site as a predictor of nivolumab efficacy in patients with advanced non-small cell lung cancer: A retrospective multicenter trial[J]. PLoS One, 2018,13(2):e0192227.
[32]Planchard D, Popat S, Kerr K, et al. Metastatic non-small cell lung cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up[J]. Ann Oncol, 2018,29 Suppl 4:iv192-iv237.
[33]Asano Y, Yamamoto N, Hayashi K, et al. Complete Response of Bone Metastasis in Non-small Cell Lung Cancer With Pembrolizumab: Two Case Reports[J]. Anticancer Res, 2021,41(3):1693-1699.
[34]Matsumoto H, Kobayashi N, Somekawa K, et al. Pembrolizumab monotherapy versus pembrolizumab plus chemotherapy in patients with non-small-cell lung cancer: A multicenter retrospective trial[J]. Thorac Cancer, 2022,13(2):228-235.
[35]Roodman GD. Mechanisms of bone metastasis[J]. N Engl J Med, 2004,350(16):1655-1664.
[36]Rosen LS, Gordon D, Tchekmedyian NS, et al. Long-term efficacy and safety of zoledronic acid in the treatment of skeletal metastases in patients with nonsmall cell lung carcinoma and other solid tumors: a randomized, Phase III, double-blind, placebo-controlled trial[J]. Cancer, 2004,100(12):2613-2621.
[37]Song Z, Zhang Y. Zoledronic acid treatment in advanced non-small cell lung cancer patients with bone metastases[J]. Med Oncol, 2014,31(4):898.
[38]Yoh K, Kubota K, Ohmatsu H, et al. Feasibility study of zoledronic acid plus cisplatin-docetaxel as first-line treatment for advanced non-small cell lung cancer with bone metastases[J]. Anticancer Res, 2012,32(9):4131-4135.
[39]Tam AH, Schepers AJ, Qin A, et al. Impact of Extended-Interval Versus Standard Dosing of Zoledronic Acid on Skeletal Events in Non-Small-Cell Lung Cancer and Small-Cell Lung Cancer Patients With Bone Metastases[J]. Ann Pharmacother, 2021,55(6):697-704.
[40]Saito G, Ebata T, Ishiwata T, et al. Risk factors for skeletal-related events in non-small cell lung cancer patients treated with bone-modifying agents[J]. Support Care Cancer, 2021,29(7):4081-4088.
[41]Cadieux B, Coleman R, Jafarinasabian P, et al. Experience with denosumab(XGEVA) for prevention of skeletal-related events in the 10 years after approval[J]. J Bone Oncol, 2022,33:100416.
[42]Lipton A, Fizazi K, Stopeck AT, et al. Superiority of denosumab to zoledronic acid for prevention of skeletal-related events: a combined analysis of 3 pivotal, randomised, phase 3 trials[J]. Eur J Cancer, 2012,48(16):3082-3092.
[43]Scagliotti GV, Hirsh V, Siena S, et al. Overall survival improvement in patients with lung cancer and bone metastases treated with denosumab versus zoledronic acid: subgroup analysis from a randomized phase 3 study[J]. J Thorac Oncol, 2012,7(12):1823-1829.

相似文献/References:

[1]张智斌,阙镇如,冉 骞,等.低温等离子刀与传统手术治疗会厌囊肿的比较分析[J].医学研究与战创伤救治(原医学研究生学报),2013,15(05):515.[doi:10.3969/j.issn.1672-271X.2013.05.028]
[2]关志华,陈立萍,黄超洋,等.鼻后滴漏综合征治疗的临床研究[J].医学研究与战创伤救治(原医学研究生学报),2011,13(03):234.
　GUAN Zhi-hua,CHEN Li-ping,HUANG Chao-yang,et al.Clinical study on the treatment of postnasal drip syndrome[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2011,13(4):234.
[3]计婧.手术期间低体温的护理[J].医学研究与战创伤救治(原医学研究生学报),2010,12(06):547.
[4]周诚忠,夏炎春,夏海波.三维适形放射治疗老年非小细胞肺癌60例[J].医学研究与战创伤救治(原医学研究生学报),2009,11(01):20.
　ZHOU Cheng-zhong,XIA Yan-chun,XIA Hai-bao.Analysis of curative effect on 60 elderly non-small cell lung cancer patients treated by three-dimensional conformal radiotherapy[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2009,11(4):20.
[5]赵志芳,张冬生,钱金黔,等.无神经症状的不稳定胸腰段爆裂性骨折 手术初探[J].医学研究与战创伤救治(原医学研究生学报),2009,11(01):25.
　ZHAO Zhi-fang,ZHANG Dong-sheng,QIAN Jin-qian,et al.Surgical treatment for thoracolumbar burst fracture without neural symptom[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2009,11(4):25.
[6]董章霞,金 燕.胆囊瓣修复肝外胆管良性病变护理体会[J].医学研究与战创伤救治(原医学研究生学报),2009,11(01):63.
[7]洪原城,林平冬,张江灵,等.晚期非小细胞肺癌骨转移的骨相关事件 及生存分析[J].医学研究与战创伤救治(原医学研究生学报),2009,11(02):124.
　HONG Yuan-cheng,LIN Ping-dong,ZHANG Jiang-ling,et al.Skeletal-related events of skeletal metastases in advanced stage non-small cell lung cancer and survival analysis[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2009,11(4):124.
[8]姚 宁,姜朝晖,方晓明,等.闭合单纯性肠系膜撕裂伤的诊治分析[J].医学研究与战创伤救治(原医学研究生学报),2009,11(02):149.
[9]姚运红.食管癌根治术后早期内心体验的质性研究[J].医学研究与战创伤救治(原医学研究生学报),2009,11(02):165.
[10]俞新胜,肖 波,汪 普,等.锁定钢板治疗肱骨近端粉碎性骨折 疗效分析[J].医学研究与战创伤救治(原医学研究生学报),2009,11(03):206.
　YU Xin-sheng,XIAO Bo,WANG Pu,et al.Analysis on the efficacy of the treatment with Locking Proximal Humeral Plate for Neer III and Ⅳ Proximal Humeral Fracture[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2009,11(4):206.

备注/Memo

备注/Memo:
基金项目：江苏省卫生健康委科研项目（M2020025）
更新日期/Last Update: 2022-09-06