As the utilization of computed tomography in lung cancer screening becomes more prevalent in the post-pandemic era, the incidence of multiple primary lung cancer (MPLC) has surged in various countries and regions. Despite the continued application of advanced histologic and sequencing technologies in this research field, the differentiation between MPLC and intrapulmonary metastasis (IM) remains challenging. In recent years, the specific mechanisms of genetic and environmental factors in MPLC have gradually come to light. Lobectomy still predominates in the treatment of MPLC, but the observation that tumor-specific sublobar resection has not detrimentally impacted survival appears to be a viable option. With the evolution of paradigms, the amalgamated treatment, primarily surgical, is an emerging trend. Among these, stereotactic ablative radiotherapy (SABR) and lung ablation techniques have emerged as efficacious treatments for early unresectable tumors and control of residual lesions. Furthermore, targeted therapies for driver-positive mutations and immunotherapy have demonstrated promising outcomes in the postoperative adjuvant phase. In this manuscript, we intend to provide an overview of the management of MPLC based on the latest discoveries. .
【中文题目：多原发肺癌诊疗策略的最新进展】 【中文摘要：随着后疫情时代的到来，计算机断层扫描在肺癌筛查中运用愈加广泛，多原发性肺癌（multiple primary lung cancer, MPLC）的检出率在不同国家和地区也随之飙升。尽管先进的组织学和测序技术不断应用于该领域，但MPLC和肺内转移（intrapulmonary metastasis, IM）的鉴别仍具有挑战性。近年来，遗传和环境因素在MPLC中的特殊机制逐渐被人们发掘。在MPLC的治疗中，肺叶切除术仍然居于主要地位，但特定肿瘤亚肺叶切除并未对生存产生负面影响，这似乎是一种合理的选择。随着理念的革新，以手术为主的综合治疗是一种新趋势。其中，立体定向消融放疗（stereotactic ablative radiotherapy, SABR）和肺消融技术成为早期不可切除肿瘤和控制残留病灶的有效治疗手段。此外，驱动基因阳性的靶向治疗和免疫治疗在术后辅助阶段也显示出良好的结果。本文拟基于最新的研究成果对MPLC的管理进行综述。 】 【中文关键词：肺肿瘤；第二代测序技术；手术；放射治疗；消融；靶向治疗；免疫治疗】.
Keywords: Ablation; Immunotherapy; Lung neoplasms; Next-generation sequencing; Radiation therapy; Surgery; Targeted therapy.