Lung squamous cell carcinoma (LSCC) is one of the common types of lung cancer, and the choice of treatment options has always been the focus of clinical attention, and the application value of neoadjuvant therapy in the treatment of LSCC has also been controversial. So, what are the benefits
of neoadjuvant therapy in clinical practice?
For some patients with lung squamous cell carcinoma, neoadjuvant therapy is very necessary. First, neoadjuvant therapy can reduce the size of tumors. When lung squamous cell carcinoma is diagnosed, the tumor may have developed to a certain size and may invade surrounding tissues and blood vessels. Chemotherapeutic drugs can reach the tumor site through blood circulation and inhibit the proliferation of tumor cells. For example, some platinum-based chemotherapy drugs can interfere with the DNA synthesis of cancer cells, so that tumor cells can not divide normally. Radiotherapy can directly irradiate local tumor tissue with high energy, destroy the genetic material and cell structure of cancer cells, and promote tumor shrinkage. When the tumor volume is reduced, the situation that the tumor is too large to be resected or is extremely difficult to be resected can be improved, the possibility and radical effect of surgical resection are improved, and the risk that the tumor can not be completely resected in the operation is reduced.
Neoadjuvant therapy also helps to reduce the activity of tumor cells and reduce the chance of metastasis of tumor cells during surgery. Surgery will inevitably cause some disturbance to the tumor tissue, which may cause tumor cells to enter the blood circulation or lymphatic system, and then form metastases in other parts of the body. Neoadjuvant chemotherapy can kill some active tumor cells, while neoadjuvant radiotherapy can cause fibrosis of blood vessels and lymphatic vessels around tumors and block the way of tumor cell metastasis. This can control the distant metastasis of tumors to a certain extent and improve the long-term survival rate of patients.
In addition, neoadjuvant therapy can provide a reference for postoperative adjuvant therapy. Through the observation of tumor response during neoadjuvant therapy, doctors can understand the sensitivity of tumors to specific drugs or treatment modalities. If the tumor shrinks significantly during the neoadjuvant phase, this treatment regimen is effective for the patient’s tumor. Then after surgery, we can continue to use similar programs for adjuvant therapy to further consolidate the therapeutic effect. On the contrary, if the tumor does not respond well to neoadjuvant therapy, we need to consider adjusting the subsequent treatment strategy and choosing more appropriate drugs or other treatment methods.
However, not all patients with lung squamous cell carcinoma are suitable for neoadjuvant therapy. For some older patients with poor physical condition, neoadjuvant therapy may bring greater side effects, affect the quality of life and physical function of patients, and may even make patients unable to tolerate subsequent surgery. For example, chemotherapy may cause nausea, vomiting, bone marrow suppression and other adverse reactions, and radiotherapy may lead to radiation pneumonia. Moreover, if the effect of neoadjuvant therapy is not ideal, it may not only delay the timing of surgery, but also make patients suffer unnecessary pain and economic burden.
In conclusion, whether neoadjuvant therapy is necessary for patients with lung squamous cell carcinoma needs to consider a variety of factors, including the stage of the tumor, the patient’s physical condition, cardiopulmonary function and so on. Doctors need to weigh the advantages and disadvantages of neoadjuvant therapy according to the specific conditions of each patient, and formulate the most appropriate individualized treatment plan for patients, so as to improve the therapeutic effect and the quality of life of patients.
