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可切除NSCLC围手术期全程免疫治疗研究进展
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Abstract:
最新流行病学数据显示，肺癌已超越乳腺癌再次跃居全球恶性肿瘤发病首位。在可切除非小细胞肺癌的临床实践中，术后复发难题始终困扰着医患双方。统计数据显示，仅接受手术治疗的早期患者中，6%~11%会出现局部复发，23%~30%面临远处转移风险。当病情进展至III期时，术后五年复发率更是攀升至60%左右，这一严峻现状凸显了传统治疗模式的局限性。近年来兴起的围手术期全程免疫疗法为破解这一困境提供了新思路，该方案通过术前阶段调节机体免疫微环境，促进免疫系统精准识别并清除肿瘤细胞，术后持续巩固免疫应答，有效清除潜在残留病灶，从而显著降低复发概率并延长患者生存期。值得注意的是，这种新型治疗策略的出现为改善患者预后开辟了新路径，其作用机制涉及肿瘤免疫循环的重建与维持，这对优化现有治疗体系具有深远影响。随着相关临床研究的深入，围术期免疫治疗的时序安排、用药方案及疗效预测等关键问题正逐步明晰，这些突破性进展不仅为个体化治疗提供了理论支撑，更为重要的是将推动肺癌治疗模式从单一外科干预向多学科协作的精准医疗转型。深入探讨这种治疗模式的最新研究进展，不仅能为临床决策提供循证依据，更有助于推动肺癌诊疗体系的优化升级，最终使更多患者获得生存获益。
The latest epidemiological data show that lung cancer has surpassed breast cancer to become the most commonly diagnosed malignant tumor globally. In the clinical practice of resectable non-small cell lung cancer, postoperative recurrence remains a persistent challenge for both physicians and patients. Statistics indicate that among early-stage patients treated with surgery alone, 6%~11% experience local recurrence, and 23%~30% face the risk of distant metastasis. When the disease progresses to stage III, the five-year postoperative recurrence rate soars to approximately 60%. This grim reality highlights the limitations of traditional treatment modalities. In recent years, the emerging comprehensive perioperative immunotherapy has provided a new solution to this dilemma. This approach involves modulating the immune microenvironment before surgery to enhance the immune system’s ability to accurately identify and eliminate tumor cells, and then consolidating the immune response after surgery to effectively clear any residual disease. This significantly reduces the recurrence rate and extends patient survival. Notably, the emergence of this novel treatment strategy has opened up a new path for improving patient prognosis, with its mechanism involving the reconstruction and maintenance of the tumor immune cycle. This has far-reaching implications for optimizing the existing treatment system. As relevant clinical research progresses, key issues such as the timing of perioperative immunotherapy, drug regimens, and efficacy prediction are becoming clearer. These breakthroughs not only provide theoretical support for personalized treatment but more importantly, they will drive the transformation of lung cancer treatment from a single surgical intervention to a multidisciplinary collaborative precision medicine model. Delving into the latest research progress of this treatment model not only provides
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