Institute of Oncology Ljubljana, Ljubljana, Slovenia.
Radiol Oncol. 2010 Jun;44(2):67-78. doi: 10.2478/v10019-010-0025-9. Epub 2010 May 24.
Given the critical role of tumor vasculature in tumor development, considerable efforts have been spent on developing therapeutic strategies targeting the tumor vascular network. A variety of agents have been developed, with two general approaches being pursued. Antiangiogenic agents (AAs) aim to interfere with the process of angiogenesis, preventing new tumor blood vessel formation. Vascular-disrupting agents (VDAs) target existing tumor vessels causing tumor ischemia and necrosis. Despite their great therapeutic potential, it has become clear that their greatest clinical utility may lie in combination with conventional anticancer therapies. Radiotherapy is a widely used treatment modality for cancer with its distinct therapeutic challenges. Thus, combining the two approaches seems reasonable.
Strong biological rationale exist for combining vascular-targeted therapies with radiation. AAs and VDAs were shown to alter the tumor microenvironment in such a way as to enhance responses to radiation. The results of preclinical and early clinical studies have confirmed the therapeutic potential of this new treatment strategy in the clinical setting. However, concerns about increased normal tissue toxicity, have been raised.
鉴于肿瘤血管在肿瘤发展中的关键作用，人们投入了大量精力来开发针对肿瘤血管网络的治疗策略。已经开发出了多种药物，主要有两种方法。抗血管生成药物（AAs）旨在干扰血管生成过程，防止新的肿瘤血管形成。血管破坏剂（VDAs）针对现有的肿瘤血管，导致肿瘤缺血和坏死。尽管它们具有巨大的治疗潜力，但很明显，它们最大的临床应用价值可能在于与传统的抗癌疗法联合使用。放射治疗是一种广泛用于癌症的治疗方法，具有独特的治疗挑战。因此，将这两种方法结合起来似乎是合理的。
将血管靶向治疗与放射治疗相结合具有很强的生物学依据。已经证明 AAs 和 VDAs 可以改变肿瘤微环境，从而增强对放射治疗的反应。临床前和早期临床研究的结果证实了这种新的治疗策略在临床环境中的治疗潜力。然而，人们对增加正常组织毒性的问题表示担忧。
