Zeng Jing, Harris Timothy J, Lim Michael, Drake Charles G, Tran Phuoc T
Department of Radiation Oncology, University of Washington, 1959 NE Pacific Street, P.O. Box 356043, Seattle, WA 98195, USA.
Biomed Res Int. 2013;2013:658126. doi: 10.1155/2013/658126. Epub 2013 Nov 14.
New and innovative treatment strategies for cancer patients in the fields of immunotherapy and radiotherapy are rapidly developing in parallel. Among the most promising preclinical treatment approaches is combining immunotherapy with radiotherapy where early data suggest synergistic effects in several tumor model systems. These studies demonstrate that radiation combined with immunotherapy can result in superior efficacy for local tumor control. More alluring is the emergence of data suggesting an equally profound systemic response also known as "abscopal" effects with the combination of radiation and certain immunotherapies. Studies addressing optimal radiation dose, fractionation, and modality to be used in combination with immunotherapy still require further exploration. However, recent anecdotal clinical reports combining stereotactic or hypofractionated radiation regimens with immunotherapy have resulted in dramatic sustained clinical responses, both local and abscopal. Technologic advances in clinical radiation therapy has made it possible to deliver hypofractionated regimens anywhere in the body using stereotactic radiation techniques, facilitating further clinical investigations. Thus, stereotactic radiation in combination with immunotherapy agents represents an exciting and potentially fruitful new space for improving cancer therapeutic responses.
免疫疗法和放射疗法领域针对癌症患者的新型创新治疗策略正在并行快速发展。最具前景的临床前治疗方法之一是将免疫疗法与放射疗法相结合，早期数据表明在多个肿瘤模型系统中存在协同效应。这些研究表明，放射疗法与免疫疗法联合使用可在局部肿瘤控制方面产生更高的疗效。更具吸引力的是，有数据显示，放射疗法与某些免疫疗法联合使用时，会出现同样显著的全身反应，即“远隔效应”。关于与免疫疗法联合使用时的最佳放射剂量、分割方式和模式的研究仍需进一步探索。然而，最近一些将立体定向或低分割放射治疗方案与免疫疗法相结合的临床案例报告显示，在局部和远隔部位均产生了显著的持续临床反应。临床放射治疗的技术进步使得使用立体定向放射技术在身体任何部位实施低分割治疗方案成为可能，这有助于进一步开展临床研究。因此，立体定向放射疗法与免疫治疗药物相结合代表了一个令人兴奋且可能成果丰硕的新领域，有望改善癌症治疗反应。
