在CAR-T细胞治疗淋巴瘤之前的桥梁放射治疗期间和之后的治疗动力学和局部反应
Daniella Klebaner1, Natalie J Park1, Mallika Marar1
1Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA, USA.
Leukemia & lymphoma
|December 26, 2025
概括
在非霍奇金淋巴瘤的CAR-T疗法之前进行过桥式放射治疗可能会改善结果. 通过体积减少定义的快速桥梁反应与复发/耐药淋巴瘤患者局部进展风险较低有关.
科学领域:
- 在瘤学瘤学.
- 辐射疗法 辐射疗法
- 免疫治疗是一种免疫疗法.
背景情况:
- 桥梁放射治疗 (BR) 在CAR-T细胞治疗非霍奇金淋巴瘤 (NHL) 之前使用.
- 对BR的最佳剂量和响应评估仍未确定.
- 复发/耐药NHL患者通常需要密集的治疗策略.
研究的目的:
- 评价BR后局部进展 (LP) 的相关值在复发/耐药NHL的患者中.
- 为了确定对BR的治疗反应的预测因素.
- 探索个性化BR战略的潜力.
主要方法:
- 用BR治疗的33名复发/耐药NHL患者的回顾性分析.
- 使用图像指导放射治疗 (IGRT) 的"快速桥梁反应" (RBR) 的定义是:在5个分数内减少≥10%的体积.
- 估计LP的累积发病率与死亡作为竞争的风险.
主要成果:
- 在5/19个LBCL和5/7个MCL患者中观察到RBR.
- 六名患者 (所有LBCL) 经历了LP (18个月累计发病率19%),没有人有RBR.
- 增加LP风险与代谢性瘤体积> 100毫升有关;在放射期间,在LP的LBCL患者中没有观察到体积变化.
结论:
- 在BR之后,RBR可能是减少局部进展的重要预测因素.
- 瘤体积和放射治疗期间的早期反应是个性化BR的潜在生物标志物.
- 需要进一步的研究来优化对接受CAR-T治疗的NHL患者的BR策略.
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