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结合CAR-T疗法与放射治疗或不结合耐火性/复发性扩散大B细胞淋巴瘤:一项比较研究

Yun Yang¹, Bichun Xu¹, Hong Zhu¹

¹Department of Radiotherapy, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China.

Clinical and translational radiation oncology

|September 24, 2025

概括

在CAR-T疗法之前的桥梁放射治疗 (BRT) 显著改善了耐药/复发性扩散大B细胞淋巴瘤 (R/R DLBCL) 患者的无进展生存率和整体生存率. BRT是一种安全有效的方法,有可能增强CAR-T的抗瘤作用.

科学领域:

血液学血液学血液学
在瘤学瘤学.
辐射瘤学辐射瘤学

背景情况:

化学抗原受体 (CAR) -T疗法在耐火性/复发性扩散性大B细胞淋巴瘤 (R/R DLBCL) 中显示出前景.
放射治疗和CAR-T疗法可能具有协同效应,改善患者的预后.
在CAR-T治疗之前,缺乏用于桥梁放射治疗 (BRT) 的标准化方案.

研究的目的:

在R/R DLBCL患者的CAR-T治疗之前评估BRT的疗效和安全性.
评估BRT剂量对患者预后的影响.
分析R/R DLBCL患者在CAR-T之前接受BRT或不接受BRT治疗的结局.

主要方法:

在2017年12月至2025年1月期间接受CAR-T治疗的80名R/R DLBCL患者的回顾性分析.
在接受BRT (n=35) 和没有接受BRT的患者之间比较结果 (PFS,OS,DSS,ORR,CRR).
放射治疗剂量 (EQD2) 和BRT模式 (综合性与焦点) 的亚组分析.

主要成果:

与没有BRT组相比,BRT组的PFS和OS显著更长 (p=0.001,p=0.043).
BRT没有增加CAR-T毒性;综合性BRT改善了PFS和OS (p=0.015,p=0.029).
高EQD2 BRT显示出改善局部控制的趋势 (p=0.079),特别是在高瘤负担患者 (p=0.005).

结论:

对于接受CAR-T治疗的R/R DLBCL患者来说,BRT是一种有效和安全的桥梁策略.
BRT可能会增强CAR-T细胞的抗瘤功效.
对最佳的BRT剂量和技术的进一步研究是有必要的.

关键词:

桥梁辐射疗法桥梁辐射疗法在CAR-T疗法中,预测预后预测预测耐火性/复发性扩散性大B细胞淋巴瘤

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