RESUMO
Oligometastatic non-small cell lung cancer (NSCLC) describes an intermediate stage of NSCLC between localized and widely-disseminated disease. This stage of NSCLC is characterized by a limited number of metastases and a more indolent tumor biology. Currently, the management of oligometastatic NSCLC involves radical treatment (radiotherapy or surgery) that targets the metastatic lesions and the primary tumor to achieve disease control. This approach offers the potential to achieve prolonged survival in patients who, in the past, would have only received palliative measures. The optimal therapeutic strategies for the different scenarios of oligometastatic disease (intracranial vs extracranial disease, synchronous vs metachronous) remain undefined. Given the lack of head-to-head studies comparing radiotherapy to surgery in these patients, the decision to apply surgery or radiotherapy (with or without systemic treatment) must be based on prognostic factors that allow us to classify patients. This classification will allow us to select the most appropriate therapeutic strategy on an individualized basis. In the future, the molecular or microRNA profiles will likely improve the treatment selection process. The objective of the present article is to review the most relevant scientific evidence on the management of patients with oligometastatic NSCLC, focusing on the role of radiotherapy and surgery. We also discuss areas of controversy and future directions.
RESUMO
El carcinoma nasofaríngeo es el tumor más frecuente que surge en la nasofaringe. Su etología es multifactorial, considerándose como factores de riesgo la distribución racial y geográfica, la infección por el virus de Epstein-Barr (VEB), así como la exposición ambiental a determinas sustancias. Esta afección es endémica en algunas zonas asiáticas, donde se han encontrado predisposición genética en su oncogénesis. Existe una fuerte susceptibilidad entre el carcinoma de nasofaríngeo y el HLA, donde se han encontrado haplotipos relacionados específicos. En zonas donde la incidencia es baja, existen pocos casos publicados sobre familias afectadas. Reportamos 3 casos de familias con carcinoma de nasofaringe entre hermanos, en población no asiática, probablemente relacionada con la infección por el VEB (AU)
Nasopharyngeal carcinoma is the predominant tumour type arising in the nasopharynx. Its aetiology is multifactorial; racial and geographical distribution, EBV infection and environmental exposure to specific substances are considered risk factors. This condition is endemic in some Asian areas, where a genetic predisposition in its oncogenesis has been established. There is a strong susceptibility between nasopharyngeal carcinoma and HLA, where related specific haplotypes have been found. In areas where the incidence is low, there are few reported cases of families affected. We report 3 cases of families with nasopharyngeal carcinoma among siblings, in the non-Asian population, probably related to EBV infection (AU)
Assuntos
Adulto , Pessoa de Meia-Idade , Idoso , Humanos , Neoplasias Nasofaríngeas/epidemiologia , Herpesvirus Humano 4/patogenicidade , Infecções por Vírus Epstein-Barr/complicações , Estudos Retrospectivos , Família , Haplótipos , Predisposição Genética para DoençaRESUMO
Nasopharyngeal carcinoma is the predominant tumour type arising in the nasopharynx. Its aetiology is multifactorial; racial and geographical distribution, EBV infection and environmental exposure to specific substances are considered risk factors. This condition is endemic in some Asian areas, where a genetic predisposition in its oncogenesis has been established. There is a strong susceptibility between nasopharyngeal carcinoma and HLA, where related specific haplotypes have been found. In areas where the incidence is low, there are few reported cases of families affected. We report 3 cases of families with nasopharyngeal carcinoma among siblings, in the non-Asian population, probably related to EBV infection.
