放免联合治疗驱动基因阴性NSCLC脑转移的 研究进展
Research Advances in Radiotherapy Combined with Immunotherapy for Driver Gene-Negative NSCLC with Brain Metastases
DOI: 10.12677/acm.2026.162732, PDF,    科研立项经费支持
作者: 张 仪, 黄玉胜, 杨镇洲*：重庆医科大学附属第二医院肿瘤中心，重庆
关键词: 非小细胞肺癌；脑转移；免疫治疗；放射治疗；驱动基因阴性；Non-Small Cell Lung Cancer； Brain Metastases； Immunotherapy； Radiotherapy； Driver Gene-Negative
摘要: 非小细胞肺癌(NSCLC)是脑转移发生率最高的实体瘤之一，在驱动基因阴性患者中，约28.8%在初诊时已存在脑转移，既往传统治疗后中位总生存期仅10~12个月。放疗作为局部控制的主要手段，整体疗效有限。免疫检查点抑制剂的出现为此类患者提供了新的系统治疗选择。研究发现，放疗通过多种途径，与免疫治疗协同增强抗肿瘤免疫。多项最新临床研究进一步证实，放疗联合免疫治疗能显著提高驱动基因阴性NSCLC脑转移患者的颅内控制率、延长生存期，且安全性总体可控。本文旨在综述该联合治疗方案在此类患者中的最新研究进展，以期为临床实践及未来治疗策略优化提供参考。
Abstract: Non-Small Cell Lung Cancer (NSCLC) is one of the solid tumors with the highest incidence of brain metastases. Among patients with driver gene-negative NSCLC, approximately 28.8% present with brain metastases at initial diagnosis, and the median overall survival with traditional treatments has historically been only 10~12 months. Radiotherapy, as the primary local control modality, shows limited efficacy. The advent of immune checkpoint inhibitors has provided a novel systemic treatment option for these patients. Research indicates that radiotherapy can synergize with immunotherapy to enhance anti-tumor immunity through multiple mechanisms. Recent clinical studies further confirm that the combination of radiotherapy and immunotherapy significantly improves intracranial control rates and prolongs survival in patients with driver gene-negative NSCLC brain metastases, with an overall manageable safety profile. This review aims to summarize the latest research progress regarding this combination therapy for such patients, in order to provide references for clinical practice and the optimization of future treatment strategies.
文章引用：张仪, 黄玉胜, 杨镇洲. 放免联合治疗驱动基因阴性NSCLC脑转移的 研究进展 [J]. 临床医学进展, 2026, 16(2): 3198-3205. https://doi.org/10.12677/acm.2026.162732

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