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在早期非小细胞肺癌中,免疫变化的模式预测了对立体除性放射治疗的反应

Jacek Rutkowski¹, Zuzanna Nowicka², Bartosz Kamil Sobocki³

¹Department of Oncology and Radiotherapy, Medical University of Gdańsk, Smoluchowskiego 17 str., 80-215, Gdańsk, Poland.

International journal of radiation oncology, biology, physics

|September 5, 2025

概括

肺癌的立体放射疗法 (SABR) 增强了免疫细胞,提高了存活率. 在SABR后PD-1+淋巴细胞和Th17反应的增加表明患者的预后有利.

科学领域:

免疫学
癌症学
放射治疗

背景情况:

对于早期非小细胞肺癌 (NSCLC) 的立体放射疗法 (SABR) 可以调节免疫系统.
了解SABR对外围淋巴细胞亚群和细胞因子水平的影响对于预测患者的结果至关重要.

研究的目的:

在早期NSCLC患者中评估SABR后的外周淋巴细胞亚群和细胞因子水平的变化.
确定这些免疫变化与总生存率 (OS) 和无病生存率 (DFS) 之间的关系.

主要方法:

对94名未经治疗的早期NSCLC患者进行前性分析.
在治疗前,2周和SABR后12周的T淋巴细胞亚群和转录因子的流细胞测量评估.
在59名患者的亚组中分析血清Th1,Th2和Th17细胞因子.

主要成果:

SABR导致PD-1+和CTLA4+细胞的早期增加和CD25或CD28表达的CD8+淋巴细胞的延迟增加.
免疫两极化与Th1和Th2细胞因子的上调有关.
患有PD-1+和RORγt+淋巴细胞早期增加的患者的生存期和DFS显著延长.

结论:

在早期的NSCLC中,SABR刺激免疫反应与临床结果相关.
在SABR后,PD-1+淋巴细胞和Th17反应的同时增加是OS和DFS的独立有利预后因素.

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