从局部控制到免疫调节:低分离放射治疗作为癌症免疫治疗的支柱
Xiaoxuan Zhuang1, Yao Sun2, Dayong Zhuang3
1Chongqing Medical University-University of Leicester Joint Institute, Chongqing Medical University, Chongqing, China.
Frontiers in oncology
|February 23, 2026
概括
低分离放射治疗 (HFRT) 通过诱导细胞死亡和T细胞激活来增强抗瘤免疫力,特别是与免疫检查点抑制剂相结合时. 理想的时间和辐射输送是成功的HFRT-免疫疗法组合的关键.
科学领域:
- 在瘤学瘤学.
- 免疫学 免疫学 免疫学
- 辐射疗法 辐射疗法
背景情况:
- 低分离放射治疗 (HFRT) 可以改善局部瘤控制,并具有免疫调节潜力.
- 高FRT通过在更少的会议中提供更高的剂量每小部分来重塑瘤免疫微环境.
研究的目的:
- 审查关于HFRT与免疫检查点抑制剂 (ICI) 和其他基于免疫的疗法的免疫作用的临床前,转化和临床证据.
- 探索HFRT如何增强全身抗瘤活性,并可能将"冷"瘤转化为"热"瘤.
主要方法:
- 从临床前研究,翻译研究和临床试验中整合证据.
- 分析HFRT对瘤细胞死亡,免疫通路 (例如cGAS-STING) 和免疫细胞贩运的影响.
- 对各种癌症类型的临床结果的评估,当HFRT与免疫疗法相结合时.
主要成果:
- 高FRT诱导免疫细胞死亡并激活cGAS-STING通路,促进树突细胞原始化和CD8+T细胞贩运.
- 结合HFRT与ICI,特别是PD-1/PD-L1阻塞在特定的周辐射治疗窗口内,可以增强全身抗瘤反应.
- 在非小细胞肺癌,头角平细胞癌和三阴性乳腺癌中观察到积极的结果;在胰腺癌等髓状或侧状主导瘤中受益有限.
结论:
- 高FRT可以通过增强免疫反应,特别是特定瘤类型,作为免疫治疗的支柱.
- 对于有效的HFRT-免疫疗法组合,仔细选择分量,时间 (辐射周边窗口) 和辐射几何 (节省淋巴结) 是至关重要的.
- 需要进一步优化临床设计,以最大限度地提高效益,并克服响应较弱的瘤中的抗性机制.
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