Higgins Geoff S, Krause Mechthild, McKenna W Gillies, Baumann Michael
Gray Laboratories, Department of Oncology, Cancer Research UK/MRC Oxford Institute for Radiation Oncology, University of Oxford, Old Road Campus Research Building, Oxford, UK.
OncoRay - National Center for Radiation Research in Oncology (NCRO), Carl Gustav Carus Faculty of Medicine, University Hospital, Technische Universität Dresden and Helmholtz-Zentrum Dresden-Rossendorf, Dresden, Germany.
Recent Results Cancer Res. 2016;198:107-22. doi: 10.1007/978-3-662-49651-0_5.
Molecular biomarkers are currently evaluated in preclinical and clinical studies in order to establish predictors for treatment decisions in radiation oncology. The receptor tyrosine kinases (RTK) are described in the following text. Among them, the most data are available for the epidermal growth factor receptor (EGFR) that plays a major role for prognosis of patients after radiotherapy, but seems also to be involved in mechanisms of radioresistance, specifically in repopulation of tumour cells between radiotherapy fractions. Monoclonal antibodies against the EGFR improve locoregional tumour control and survival when applied during radiotherapy, however, the effects are heterogeneous and biomarkers for patient selection are warranted. Also other RTK´s such as c-Met and IGF-1R seem to play important roles in tumour radioresistance. Beside the potential to select patients for molecular targeting approaches combined with radiotherapy, studies are also needed to evluate radiotherapy adaptation approaches for selected patients, i.e. adaptation of radiation dose, or, more sophisticated, of target volumes.
目前正在临床前和临床研究中评估分子生物标志物，以便为放射肿瘤学的治疗决策建立预测指标。以下将描述受体酪氨酸激酶（RTK）。其中，关于表皮生长因子受体（EGFR）的数据最多，EGFR对放疗后患者的预后起着重要作用，但似乎也参与了放射抗性机制，特别是在放疗分次之间肿瘤细胞的再增殖过程中。在放疗期间应用针对EGFR的单克隆抗体可改善局部肿瘤控制和生存率，然而，效果存在异质性，因此有必要建立用于患者选择的生物标志物。其他RTK，如c-Met和IGF-1R，似乎在肿瘤放射抗性中也发挥着重要作用。除了有潜力为分子靶向联合放疗选择患者外，还需要开展研究来评估针对特定患者的放疗适应性方法，即调整辐射剂量，或者更复杂的是调整靶区体积。
