ALK阳性NSCLC脑转移放疗的研究进展

doi:10.3760/cma.j.cn371439-20250123-00063

国际肿瘤学杂志 ›› 2025, Vol. 52 ›› Issue (6): 374-378.doi: 10.3760/cma.j.cn371439-20250123-00063

ALK阳性NSCLC脑转移放疗的研究进展

钟啸, 李步托, 王琳琳()

山东省肿瘤防治研究院（山东省肿瘤医院）放疗科山东第一医科大学（山东省医学科学院），济南 250117

收稿日期:2025-01-23 修回日期:2025-02-21 出版日期:2025-06-08 发布日期:2025-06-26
通讯作者: 王琳琳 E-mail:llwang@sdfmu.edu.cn
基金资助:
国家自然科学基金(82172865);国家重点技术研发计划(2022YFC2404605);山东省自然科学基金(ZR2021LZL009);山东省自然科学基金(ZR2023LZL002);山东省自然科学基金(ZR2024MH007);创新药物上市后临床研究科研专项(WKZX 2023CX020012);吴阶平医学基金临床研究专项基金(320.6750.2021-02-51);吴阶平医学基金临床研究专项基金(320.6750.2021-17-13)

Research progress of radiotherapy for brain metastases from ALK-positive NSCLC

Zhong Xiao, Li Butuo, Wang Linlin()

Department of Radiation Oncology， Shandong Cancer Hospital and Institute， Shandong First Medical University & Shandong Academy of Medical Sciences， Jinan 250117， China

Received:2025-01-23 Revised:2025-02-21 Online:2025-06-08 Published:2025-06-26
Contact: Wang Linlin E-mail:llwang@sdfmu.edu.cn
Supported by:
National Natural Science Foundation of China(82172865);National Key Technologies Research and Development Program(2022YFC2404605);Natural Science Foundation of Shandong Province of China(ZR2021LZL009);Natural Science Foundation of Shandong Province of China(ZR2023LZL002);Natural Science Foundation of Shandong Province of China(ZR2024MH007);Post-Marketing Clinical Research Special Project on Innovative Drugs(WKZX 2023CX020012);Clinical Research Special Fund of Wu Jieping Medical Foundation(320.6750.2021-02-51);Clinical Research Special Fund of Wu Jieping Medical Foundation(320.6750.2021-17-13)

摘要/Abstract

摘要：

脑转移在间变性淋巴瘤激酶（ALK）阳性非小细胞肺癌（NSCLC）患者中较常见，第一代至第三代ALK-酪氨酸激酶抑制剂（TKI）已广泛应用于ALK阳性脑转移的治疗，但仍有部分患者颅内控制不佳。一代ALK-TKI不能透过血脑屏障，联合颅脑放疗可显著改善颅内控制；二、三代ALK-TKI可透过血脑屏障，具有更好的颅内控制，联合放疗的获益人群及介入时机仍存在争议。ALK-TKI联合颅脑放疗的方式目前尚无定论，但应结合患者既往放疗史、靶向药物种类、脑转移灶数量、ALK-TKI间隔时间等综合考虑，并需密切监测脑坏死等放疗相关不良反应。

关键词: 癌，非小细胞肺, 肿瘤转移, 间变性淋巴瘤激酶, 放射疗法, 分子靶向治疗

Abstract:

Brain metastases are relatively common in anaplastic lymphoma kinase （ALK）-positive non-small cell lung cancer （NSCLC） patients. Although first-to third-generation ALK-tyrosine kinase inhibitors （TKI） have been widely used in the treatment of ALK-positive patients with brain metastases， some patients still experience inadequate intracranial control. First-generation ALK-TKI cannot penetrate the blood-brain barrier， and the addition of brain radiotherapy significantly improves intracranial control. In contrast， second- and third-generation ALK-TKI can cross the blood-brain barrier， offering better intracranial control. However， the beneficiary population and optimal timing for combining radiotherapy remain controversial. The optimal approach for combining ALK-TKI with cranial radiotherapy remains inconclusive. It should be determined by comprehensively considering factors such as prior radiotherapy history， the type of targeted drugs， the number of brain metastases， the interval time of ALK-TKI， and others. Close monitoring for radiotherapy-related adverse effects， such as brain necrosis， is also essential.

Key words: Carcinoma， non-small-cell lung, Neoplasm metastasis, Anaplastic lymphoma kinase, Radiotherapy, Molecular targeted therapy

钟啸, 李步托, 王琳琳. ALK阳性NSCLC脑转移放疗的研究进展[J]. 国际肿瘤学杂志, 2025, 52(6): 374-378.

Zhong Xiao, Li Butuo, Wang Linlin. Research progress of radiotherapy for brain metastases from ALK-positive NSCLC[J]. Journal of International Oncology, 2025, 52(6): 374-378.

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ALK阳性NSCLC脑转移放疗的研究进展

Research progress of radiotherapy for brain metastases from ALK-positive NSCLC

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