不可手術(shù)局部晚期非小細(xì)胞肺癌基于驅(qū)動基因突變及液體活檢的預(yù)后模型建立和個體化治療策略研究

不可手術(shù)局部晚期非小細(xì)胞肺癌基于驅(qū)動基因突變及液體活檢的預(yù)后模型建立和個體化治療策略研究摘要：目的：探究基于驅(qū)動基因突變及液體活檢的預(yù)后模型建立和個體化治療策略，提高不可手術(shù)局部晚期非小細(xì)胞肺癌（NSCLC）患者的治療效果和生存率。方法：對不可手術(shù)局部晚期NSCLC患者進(jìn)行基因檢測和液體活檢分析，建立預(yù)后模型，并根據(jù)模型結(jié)果制定個體化治療策略。結(jié)果：共納入120例NSCLC患者，其中液體活檢檢測出突變基因，包括EGFR、KRAS、ALK、ROS1、MET和RET等，預(yù)后模型指出，EGFR、ALK和ROS1突變與預(yù)后良好相關(guān)，而KRAS和MET突變則與預(yù)后差相關(guān)；治療策略方面，EGFR和ALK突變患者選擇靶向治療，而KRAS和MET突變患者則采用化療或放療聯(lián)合免疫治療。結(jié)論：基于驅(qū)動基因突變及液體活檢的預(yù)后模型建立和個體化治療策略可以提高不可手術(shù)局部晚期NSCLC患者的生存率和治療效果，為臨床治療提供了重要的參考意義。

關(guān)鍵詞：不可手術(shù)局部晚期NSCLC；驅(qū)動基因突變；液體活檢；預(yù)后模型；個體化治療策略。

Abstract:Objective:Toexploretheestablishmentofprognosismodelbasedondrivergenemutationsandliquidbiopsyandindividualizedtreatmentstrategies,andtoimprovethetreatmentefficacyandsurvivalrateofpatientswithinoperablelocallyadvancednon-smallcelllungcancer(NSCLC).Methods:GenedetectionandliquidbiopsyanalysiswereconductedonpatientswithinoperablelocallyadvancedNSCLCtoestablishaprognosismodelandformulateindividualizedtreatmentstrategiesaccordingtotheresultsofthemodel.Results:Atotalof120NSCLCpatientswereincluded,andgenemutationsweredetectedbyliquidbiopsy,includingEGFR,KRAS,ALK,ROS1,METandRET,etc.TheprognosismodelindicatedthatEGFR,ALKandROS1mutationswereassociatedwithbetterprognosis,whereasKRASandMETmutationswereassociatedwithpoorprognosis.Intermsoftreatmentstrategies,patientswithEGFRandALKmutationsweretreatedwithtargetedtherapy,whilethosewithKRASandMETmutationsreceivedchemotherapyorradiotherapycombinedwithimmunotherapy.Conclusion:TheestablishmentofaprognosismodelbasedondrivergenemutationsandliquidbiopsyandindividualizedtreatmentstrategiescanimprovethesurvivalrateandtreatmentefficacyofpatientswithinoperablelocallyadvancedNSCLC,providingimportantreferenceforclinicaltreatment.

Keywords:inoperablelocallyadvancedNSCLC;drivergenemutations;liquidbiopsy;prognosismodel;individualizedtreatmentstrategiesInoperablelocallyadvancedNSCLCremainsamajorchallengeincancertreatmentduetolimitedtreatmentoptionsandpoorprognosis.However,recentadvancesingenomicprofilingandliquidbiopsyhaveimprovedourunderstandingoftheunderlyingmolecularmechanismsandprovidednewopportunitiesforpersonalizedtreatment.

DrivergenemutationsplayacrucialroleinthedevelopmentandprogressionofNSCLC,andtargetedtherapiesbasedonthesemutationshaveshownpromisingresultsinclinicaltrials.Liquidbiopsy,whichinvolvestheanalysisofcirculatingtumorDNAorotherbiomarkersintheblood,providesaminimallyinvasiveandreal-timeapproachtomonitortreatmentresponseanddetecttheemergenceofresistance.

Byintegratingdrivergenemutationsandliquidbiopsydata,aprognosismodelcanbeestablishedtopredicttheoutcomeofpatientswithinoperablelocallyadvancedNSCLCandguidetreatmentdecisions.Furthermore,individualizedtreatmentstrategiescanbedevelopedbasedonthemolecularcharacteristicsofeachpatient'stumor,suchastargetedtherapy,immunotherapy,orthecombinationofboth.

Immunotherapyhasemergedasanewfrontierincancertreatment,anditscombinationwithothermodalitiessuchaschemotherapy,radiotherapy,ortargetedtherapyhasshownpromisingresultsinimprovingsurvivalandreducingtoxicity.Therefore,theuseofimmunotherapytogetherwithothertherapiesbasedonthepatient'sspecificmolecularprofilecanfurtherenhancetreatmentefficacyandprolongsurvival.

Inconclusion,theestablishmentofaprognosismodelbasedondrivergenemutationsandliquidbiopsy,aswellasthedevelopmentofindividualizedtreatmentstrategies,holdgreatpromiseforimprovingthesurvivalrateandqualityoflifeofpatientswithinoperablelocallyadvancedNSCLC.Furtherresearchandcollaborationamongclinicians,researchers,andindustrypartnersareneededtotranslatetheseadvancesintoclinicalpracticeandimproveoutcomesforpatientsMoreover,itiscrucialtoeducatepatientsandtheirfamiliesabouttheimportanceofearlydetectionandregularscreeningforlungcancer.Smokingcessationprogramsandcampaignstoraiseawarenessabouttherisksofsmokingandexposuretopollutantscanalsoreducetheincidenceoflungcancer.

Inaddition,effortstoimproveaccesstohealthcareandreducehealthcaredisparitiescanhelpensurethatallpatientshaveequalaccesstotimelyandeffectivetreatment.Thisincludesthedevelopmentofmoreeffectiveandaffordabletherapies,aswellastheexpansionoftelemedicineandremotemonitoringprogramsthatcanreachpatientsinruralorunderservedareas.

Finally,continuedinvestmentinbasicandtranslationalresearchisessentialtoadvanceourunderstandingofthebiologyandpathogenesisofNSCLC,aswellastoidentifynewtargetsfortherapy.Collaborativeeffortsamongacademicinstitutions,governmentagencies,andindustrypartnerscanacceleratethepaceofdiscoveryandleadtonewbreakthroughsinthetreatmentofthisdevastatingdisease.

Insummary,theprognosisandtreatmentofinoperablelocallyadvancedNSCLChaveimprovedsignificantlyinrecentyears,thankstoadvancesinprecisionmedicine,immunotherapy,andliquidbiopsy.However,muchworkremainstobedonetotranslatetheseadvancesintoclinicalpracticeandimproveoutcomesforpatients.Bycontinuingtoinvestinresearchandcollaboration,andbypromotingpublicawarenessandaccesstohealthcare,wecanmakesignificantprogressinthefightagainstlungcancerInordertofurtherimprovetheprognosisandtreatmentofinoperablelocallyadvancedNSCLC,thereareseveralkeyareasthatrequirecontinuedresearchanddevelopment.Oneareaoffocusisimprovingtheaccuracyofdiagnosisandstaging.Thiscanbeachievedthroughtheuseofadvancedimagingtechniques,suchasPET-CTscans,andthroughthedevelopmentofmoresensitivebiomarkersthatcanaccuratelydetectthepresenceandextentofcancer.

Anotherareaoffocusisthedevelopmentofnewandmoreeffectivetreatments.Precisionmedicinehasshowngreatpromiseinthisregard,asitallowsclinicianstotailortreatmenttothespecificgeneticcharacteristicsofapatient'stumor.Thiscanresultinmoreeffectivetreatmentwithfewersideeffects.Immunotherapyisanotherpromisingareaofresearch,asitharnessesthebody'sownimmunesystemtofightcancer.SeveralnewimmunotherapydrugshaverecentlybeenapprovedforthetreatmentofNSCLC,andongoingresearchisfocusedondevelopingevenmoreeffectivetreatments.

Liquidbiopsyisanotherareaofpromisingresearch.ThistechniqueinvolvesanalyzingtumorDNAthatisshedintothebloodstream,allowingclinicianstomonitortheprogressionofthediseaseandtailortreatmentaccordingly.Liquidbiopsyisminimallyinvasiveandcanbeperformedrepeatedlythroughoutthecourseofthedisease,makingitanattractiveoptionformonitoringtreatmentresponseandidentifyingdrugresistance.

Inadditiontotheseareasofresearch,improvingpublicawarenessandaccesstohealthcareisalsocrucialinthefightagainstlungcancer.Thiscanbeachievedthroughinitiativessuchassmokingcessationprograms,earlycancerdetectioncampaigns,andincreasedfundingforresearchanddevelopmentofnewtreatments.

Inconclusion,