Cómo integrar la radioterapia estereotáxica fraccionada y el hipofraccionamiento en el manejo del cáncer de pulmón localmente avanzado en la era de la inmunoterapia
DOI:
https://doi.org/10.23938/ASSN.0855Palabras clave:
Cáncer de pulmón., Hipofraccionamiento., SBRT., Inmunoterapia.Resumen
Los constantes avances en el campo de la inmunoterapia en cáncer de pulmón se han visto reflejados en la aprobación de durvalumab para el tratamiento de la enfermedad localmente avanzada tras radioterapia y quimioterapia concurrente. Sin embargo, la radioterapia sigue siendo clave para el control de la enfermedad en este estadio. A lo largo de los años se han utilizado varias estrategias para tratar de optimizar su papel, siendo la toxicidad cardíaca y la pulmonar las principales barreras. En este contexto, el interés por el uso del hipofraccionamiento y la radioterapia estereotáxica fraccionada para el cáncer de pulmón no microcítico estadio III ha ido en aumento. El hipofraccionamiento es un tratamiento relativamente extendido aunque el nivel de evidencia que lo acompaña sea limitado. Por su parte, la radioterapia estereotáxica fraccionada se ha estudiado especialmente como una técnica para sobredosificar áreas concretas de la enfermedad tras el tratamiento con radioquimioterapia. En ambos casos, el estudio de cómo integrar estas herramientas radioterápicas con la quimioterapia, y especialmente con la inmunoterapia, es esencial, dado que pueden jugar además un papel inmunomodulador.
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