Wong Jeffrey Y C
Division of Radiation Oncology and Radiation Research, City of Hope National Medical Center and Beckman Research Institute, Duarte, CA, USA.
Int J Radiat Oncol Biol Phys. 2006;66(2 Suppl):S74-82. doi: 10.1016/j.ijrobp.2005.05.029.
Radiation oncology is entering an exciting new era with therapies being delivered in a targeted fashion through an increasing number of novel approaches. External beam radiotherapy now integrates functional and anatomic tumor imaging to guide delivery of conformal radiation to the tumor target. Systemic targeted radionuclide therapy (STaRT) adds an important new dimension by making available to the radiation oncologist biologically targeted radiation therapy. Impressive clinical results with antibody-targeted radiotherapy, leading to the Food and Drug Administration's approval of two anti-CD20 radiolabeled antibodies, highlight the potential of STaRT. Optimization strategies will further improve the efficacy of STaRT by improving delivery systems, modifying the tumor microenvironment to increase targeted dose, and maximizing dose effect. Ultimately, the greatest potential for STaRT will not be as monotherapy, but as therapy integrated into established multimodality regimens and used as adjuvant or consolidative therapy in patients with minimal or micrometastatic disease.
放射肿瘤学正进入一个令人兴奋的新时代，通过越来越多的新方法以靶向方式进行治疗。外照射放疗现在整合了功能和解剖肿瘤成像，以指导向肿瘤靶区递送适形放疗。全身靶向放射性核素治疗（STaRT）通过为放射肿瘤学家提供生物靶向放射治疗增加了一个重要的新维度。抗体靶向放疗取得了令人印象深刻的临床结果，导致美国食品药品监督管理局批准了两种抗CD20放射性标记抗体，突出了STaRT的潜力。优化策略将通过改进递送系统、改变肿瘤微环境以增加靶向剂量以及最大化剂量效应来进一步提高STaRT的疗效。最终，STaRT的最大潜力不在于作为单一疗法，而在于作为已确立的多模式治疗方案的一部分进行治疗，并用于微小或微转移疾病患者的辅助或巩固治疗。
