在2025年欧洲肺癌大会（ELCC）“寡转移疾病”教育专场，法国古斯塔夫·鲁西癌症中心放射肿瘤科专家Antonin Levy，MD，PhD作题为《寡转移疾病管理的突破进展》的报告，并接受《肿瘤瞭望》专访，深度剖析寡转移性肺癌的定义争议与临床实践挑战！

 

Dr.Levy:我来自法国维勒瑞夫的古斯塔夫·鲁西癌症中心（Gustave Roussy Cancer Centre），是一名放射肿瘤学家和放射肿瘤科副教授。我们科室还设有一间专门从事基础研究和转化研究的实验室。

 

寡转移是指转移灶数量有限（通常为3-5个）的一种状态，可通过18F-FDG PET-CT和脑磁共振成像(MRI)检测出来。多个国家级科学协会正在努力完善这一定义，需要考虑多种临床情况：

 

同步寡转移：原发肿瘤与少量转移灶同时存在。

 

异时性寡转移疾病：原发肿瘤治疗后数月内出现转移性病变。

 

寡进展：在全身治疗期间，虽然大多数肿瘤对治疗有反应，但少数病灶对治疗产生耐药。

 

寡持续：全身治疗后，大多数原发转移性病变消失，但少数原有病灶仍持续存在活性。

 

Dr.Levy:I’m Antonin Levy，a radiation oncologist at Gustave Roussy Cancer Centre in Villejuif，France.I hold both an MD and PhD and serve as an Associate Professor in the Department of Radiation Oncology，where we also have a laboratory dedicated to basic and translational research.

 

Oligometastatic disease refers to a state where there are a limited number of metastatic lesions—generally fewer than 3 to 5，as detected on 18FDG PET-CT and brain MRI.Several national and scientific societies are working to refine the definition，and there are multiple clinical scenarios to consider:

 

●Synchronous oligometastasis:The patient presents with both the primary tumor and a few metastatic lesions at the same time.

 

●Metachronous oligometastasis:The primary tumor has been treated，and metastatic lesions appear months later.

 

●Oligoprogression:During systemic therapy，while most disease responds，a few lesions become resistant.

 

●Oligopersistence:Following systemic therapy，most initial metastatic disease disappears，but a few pre-existing lesions continue to show signs of activity.

 

Dr.Levy:一些小型随机II期试验表明，对转移灶添加局部治疗（如放射治疗）可能会改善疗效。然而，我们仍然需要针对每种具体的寡转移情况，从III期试验中获得更可靠的数据，现有证据仍有限。

 

根据ESMO指南建议，局部治疗可在寡转移多学科讨论时被考虑，但其尚未被确立为标准治疗，该领域正在等待更有力的III期研究数据。

 

2025 ELCC有一项壁报和一些回顾性研究聚焦了寡转移性疾病，但没有展示任何重要的试验数据。我们期待随后将发布的针对寡转移的大型III期试验结果，这些研究结果可能会在欧洲放射治疗和肿瘤学会（ESTRO）年会、美国临床肿瘤学会（ASCO）年会或世界肺癌大会（WCLC）上公布。我们正热切期待这些数据！

 

Dr.Levy:Some small randomized phase II trials suggest that adding local treatments(such as radiotherapy)to metastases may improve outcomes.However，we still need more robust data from phase III trials tailored to each specific oligometastatic scenario.As of now，the evidence remains limited.

 

According to the ESMO Guidelines，local treatment may be considered during multidisciplinary board discussions，but it is not yet established as a standard-of-care.The field is waiting for stronger phase III evidence.

 

At ELCC 2025，in terms of the oligometastatic setting，there was one poster and some retrospective data，but no major trials presented.Later this year we expect results from a large phase III trial addressing this topic.These results will likely be shared at the ESTRO Radiation Oncology Congress，ASCO，or the World Lung Cancer Congress.We are eagerly awaiting that data.

 

《肿瘤瞭望》在ELCC现场报道