摘要原发性肺癌（以下简称肺癌）是中国发病率和死亡率最高的恶性肿瘤。2022年中国肺癌新发病例约106.06万例，死亡约73.33万例。虽然人们对肿瘤筛查和早诊的意识有所提高，但大部分肺癌患者就诊时已是Ⅳ期。以全身治疗为主的多学科综合治疗是Ⅳ期肺癌患者的治疗原则，化疗是Ⅳ期肺癌治疗的基石，但疗效欠佳。近年来，随着分子靶向治疗、免疫治疗的飞速发展，Ⅳ期肺癌的治疗理念在不断更新，患者的治疗效果得到了很大改善。为了及时更新国内外Ⅳ期肺癌的治疗进展，进一步提高中国Ⅳ期肺癌患者的规范化诊疗水平，中国医疗保健国际交流促进会肿瘤内科学分会和中国医师协会肿瘤医师分会组织专家编写了《Ⅳ期原发性肺癌中国治疗指南（2026版）》。指南在《Ⅳ期原发性肺癌中国治疗指南（2021年版）》《Ⅳ期原发性肺癌中国治疗指南（2023年版）》和《Ⅳ期原发性肺癌中国治疗指南（2024版）》的基础上对2025年10月31日之前获得中国国家药品监督管理局批准上市的新药、新治疗方案和新适应证进行了系统、全面地更新。指南涵盖了Ⅳ期肺癌诊治过程中常见的临床问题和相应指导建议，旨在对Ⅳ期肺癌临床诊疗工作提供帮助，全面提高中国Ⅳ期肺癌规范化诊治水平，以期延长Ⅳ期肺癌患者生存时间、改善生活质量。

abstractsPrimary lung cancer (abbreviated as lung cancer) stands as the most prevalent malignant disease and the leading cause of cancer-related death in China, with an estimated 1.06 million new cases and 733 300 deaths in 2022. Despite increased public awareness of cancer screening and early diagnosis, most of lung cancer patients are in stage Ⅳ when diagnosed. Multi-disciplinary treatment based on systemic therapy is the treatment principle for patients with stage Ⅳ lung cancer. Chemotherapy remains the cornerstone, but its effectiveness is still unsatisfactory. In recent years, with the rapid development of molecular targeted therapy and immunotherapy, the treatment paradigm for stage Ⅳ lung cancer has been continually evolving, leading to significant improvements in patient treatment outcomes. To ensure timely updates on the global progress in the treatment of stage Ⅳ lung cancer and further improve the level of standardized diagnosis and treatment of stage Ⅳ lung cancer in China, the Medical Oncology Branch of China International Exchange and Promotive Association for Medical and Health Care and the Chinese Association for Clinical Oncologists organized experts to compile "China clinical practice guideline for stage Ⅳ primary lung cancer (2026 edition)". This guideline systematically and comprehensively updates new drugs, new treatment regimens, and new indications approved by the China National Medical Products Administration before October 31, 2025, based on the "Clinical practice guideline for stage Ⅳ primary lung cancer in China (2021 version)", the " Clinical practice guideline for stage Ⅳ primary lung cancer in China (2023 edition)" and "China clinical practice guideline for stage Ⅳ primary lung cancer (2024 edition)". This guideline covers common clinical issues and corresponding guidance in the diagnosis and treatment process of stage Ⅳ lung cancer. This guideline aims to provide help for the clinical practice of stage Ⅳ lung cancer, comprehensively improve the standardized diagnosis and treatment level in China, prolong the survival time of patients with stage Ⅳ lung cancer, and improve their quality of life.