放射治疗剂量在接受免疫治疗的患者中
Kelly J Fitzgerald1, Jonathan D Schoenfeld1
1Brigham and Women's Hospital, Boston, MA.
Seminars in radiation oncology
|June 18, 2023
概括
结合放射治疗 (RT) 和免疫瘤学 (IO) 需要了解最佳的RT剂量. 不同剂量影响瘤细胞和免疫微环境,但可靠地产生像abscopal效应这样的全身效应仍然具有挑战性.
科学领域:
- 在瘤学瘤学.
- 辐射瘤学 辐射瘤学
- 免疫学 免疫学 免疫学
背景情况:
- 将放射治疗 (RT) 与免疫瘤学 (IO) 药物结合起来是一个有希望的策略.
- 组合治疗的最佳RT参数尚未确定.
- RT剂量影响瘤免疫微环境调节和细胞杀伤.
研究的目的:
- 审查研究RT和IO组合的关键临床试验.
- 专注于不同RT剂量对治疗结果的影响.
- 探索RT-IO疗法的挑战和未来方向.
主要方法:
- 在RT和IO中完成和正在进行的临床试验的审查.
- 分析RT剂量分化及其对瘤反应和毒性的影响.
- 检查产生全身抗瘤免疫力的策略 (abscopal效应).
主要成果:
- 低剂量的RT调节瘤的免疫微环境.
- 中间RT剂量可以杀死瘤细胞并调节免疫力.
- 消耗性RT剂量可以消除瘤细胞,具有潜在的免疫调节作用,但有毒性风险.
- 难以可靠地产生abscopal效应. 这是困难的.
- 较新的试验探索全身或个性化RT与IO.
结论:
- 选择RT剂量对于优化RT-IO疗效和控制毒性至关重要.
- 需要进一步的研究来克服在实现系统效应方面面临的挑战.
- 在早期疾病阶段和与其他模式相结合探索RT-IO有希望.
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