Department of Oncology and Radiotherapy, Medical University of Gdańsk, Poland.
Cancer Treat Rev. 2010 May;36(3):268-75. doi: 10.1016/j.ctrv.2009.12.001. Epub 2009 Dec 30.
Radiotherapy is associated with several toxicities affecting healthy tissues. One of the strategies aimed at decreasing radiation toxicity is the use of radioprotective agents, such as amifostine and palifermin, or factors stimulating hemopoetic stem cells (colony stimulating factors, CSFs): granulocyte-CSF, granulocyte macrophage-CSF and recombinant erythropoetins. The potential beneficial effect of these substances demonstrated in preclinical in vitro and in vivo studies led to numerous clinical trials. This review addresses the current experience on the use of cytoprotective agents in combination with radiotherapy, with particular focus on the safety of these approaches. Despite a relatively large body of literature data, the role of cytoprotective agents combined with radiotherapy remains controversial. Overall, their use in this application is still limited due to modest radioprotective effect for normal tissues, potential risk of tumor protection and increased treatment toxicity. The use of erythropoetins in combination with radiotherapy should generally be discouraged, whereas the safe and effective application of other agents warrants further investigations.
放射治疗与多种影响健康组织的毒性作用有关。减少放射毒性的策略之一是使用放射保护剂，如氨磷汀和培非格司亭，或刺激造血干细胞的因子（集落刺激因子，CSFs）：粒细胞集落刺激因子、粒细胞巨噬细胞集落刺激因子和重组红细胞生成素。这些物质在临床前的体外和体内研究中表现出的潜在有益效果，促使进行了许多临床试验。本综述讨论了联合放射治疗使用细胞保护剂的现有经验，特别关注这些方法的安全性。尽管有大量的文献数据，但联合放射治疗使用细胞保护剂的作用仍存在争议。总的来说，由于对正常组织的放射保护作用有限、潜在的肿瘤保护风险和增加治疗毒性，这些药物在该应用中的使用仍然受到限制。一般来说，不应该鼓励将红细胞生成素与放射治疗联合使用，而其他药物的安全有效应用需要进一步研究。
