新辅助化疗在非小细胞肺癌中的应用与研究进展
The Application and Research Progress of Neoadjuvant Chemotherapy in Non-Small Cell Lung Cancer
DOI: 10.12677/acm.2025.15102935, PDF,   
作者: 常艳龙, 周鑫涛, 侯文宇, 王 强*：内蒙古民族大学第二临床医学院(内蒙古林业总医院)，内蒙古 牙克石
关键词: 新辅助化疗；非小细胞癌；生物标志物；病理缓解；免疫治疗；Neoadjuvant Chemotherapy； Non-Small Cell Lung Cancer； Biomarkers； Pathological Remission； Immunotherapy
摘要: 非小细胞肺癌(NSCLC)是全球范围内发病率和死亡率最高的恶性肿瘤之一。新辅助化疗作为围手术期综合治疗的重要组成部分，近年来在改善患者预后方面发挥了关键作用。本文旨在综述NSCLC新辅助化疗的基础理论、流行病学特征、诊断与评估方法、治疗策略、临床实践以及未来研究方向。本文基于近年来国内外临床试验和基础研究成果，系统梳理新辅助化疗在NSCLC中的应用进展，并从病理机制、药物作用机制、影像学评估、病理缓解的临床意义、生物标志物探索等方面进行深入分析。新辅助化疗可通过缩小肿瘤体积、降低微转移风险，提高肿瘤切除率和患者长期生存率。不同病理亚型(鳞癌vs腺癌)在新辅助策略上存在差异；关键生物标志物(如ctDNA、PD-L1、TMB等)及影像学进展为疗效预测和个体化治疗提供了可能。结合免疫治疗和靶向治疗的新型新辅助模式正在成为研究热点。新辅助化疗在NSCLC中具有重要价值，但如何实现精准分层和个体化管理仍是关键挑战。未来应聚焦于多模态生物标志物的整合应用、AI与影像/病理学评估结合、以及创新药物与新技术的临床转化，以期进一步优化围手术期治疗策略并改善患者预后。
Abstract: Non-small cell lung cancer (NSCLC) is one of the malignant tumors with the highest incidence and mortality rates worldwide. Neoadjuvant chemotherapy, as an important component of perioperative comprehensive treatment, has played a key role in improving patient prognosis in recent years. This article aims to review the basic theory, epidemiological characteristics, diagnostic and evaluation methods, treatment strategies, clinical practice, and future research directions of neoadjuvant chemotherapy for NSCLC. Based on the clinical trials and basic research results at home and abroad in recent years, this article systematically reviews the application progress of neoadjuvant chemotherapy in NSCLC and conducts in-depth analysis from aspects such as pathological mechanisms, drug action mechanisms, imaging evaluation, clinical significance of pathological remission, and exploration of biomarkers. Neoadjuvant chemotherapy can reduce tumor volume, lower the risk of micrometastasis, increase tumor resection rate and long-term survival rate of patients. There are differences in neoadjuvant strategies between different pathological subtypes (squamous cell carcinoma vs adenocarcinoma); key biomarkers (such as ctDNA, PD-L1, TMB, etc.) and imaging progress provide possibilities for efficacy prediction and individualized treatment. The new neoadjuvant model combining immunotherapy and targeted therapy is becoming a research hotspot. Neoadjuvant chemotherapy has significant value in NSCLC, but how to achieve precise stratification and individualized management remains a key challenge. In the future, efforts should be focused on the integrated application of multimodal biomarkers, the combination of AI with imaging/pathological evaluation, and the clinical transformation of innovative drugs and new technologies, in order to further optimize perioperative treatment strategies and improve patient prognosis.
文章引用：常艳龙, 周鑫涛, 侯文宇, 王强. 新辅助化疗在非小细胞肺癌中的应用与研究进展[J]. 临床医学进展, 2025, 15(10): 1689-1700. https://doi.org/10.12677/acm.2025.15102935

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