Schaue Dörthe
Department of Radiation Oncology, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA, USA.
Front Immunol. 2017 Apr 11;8:431. doi: 10.3389/fimmu.2017.00431. eCollection 2017.
The coming of age for immunotherapy (IT) as a genuine treatment option for cancer patients through the development of new and effective agents, in particular immune checkpoint inhibitors, has led to a huge renaissance of an old idea, namely to harness the power of the immune system to that of radiation therapy (RT). It is not an overstatement to say that the combination of RT with IT has provided a new conceptual platform that has re-energized the field of radiation oncology as a whole. One only has to look at the immense rise in sessions at professional conferences and in grant applications dealing with this topic to see its emergence as a force, while the number of published reviews on the topic is staggering. At the time of writing, over 97 clinical trials have been registered using checkpoint inhibitors with RT to treat almost 7,000 patients, driven in part by strong competition between pharmaceutical products eager to find their market niche. Yet, for the most part, this enthusiasm is based on relatively limited recent data, and on the clinical success of immune checkpoint inhibitors as single agents. A few preclinical studies on RT-IT combinations have added real value to our understanding of these complex interactions, but many assumptions remain. It seems therefore appropriate to go back in time and pull together what actually has been a long history of investigations into radiation and the immune system (Figure 1) in an effort to provide context for this interesting combination of cancer therapies.
免疫疗法（IT）通过研发新型有效药物，尤其是免疫检查点抑制剂，成为癌症患者切实可行的治疗选择，这使得一个古老的理念得以复兴，即利用免疫系统的力量来协同放射治疗（RT）。毫不夸张地说，RT与IT的联合提供了一个新的概念平台，为整个放射肿瘤学领域注入了新的活力。只需看看专业会议上关于该主题的会议场次以及资助申请数量的大幅增加，就能明白它已成为一股重要力量，同时关于该主题的已发表综述数量也惊人。在撰写本文时，已有超过97项临床试验注册，使用检查点抑制剂联合RT治疗近7000名患者，这在一定程度上是由于急于寻找市场定位的制药产品之间的激烈竞争所致。然而，在很大程度上，这种热情是基于相对有限的近期数据以及免疫检查点抑制剂作为单一药物的临床成功。一些关于RT - IT联合治疗的临床前研究为我们理解这些复杂相互作用增添了实际价值，但仍存在许多假设。因此，回顾过去，汇总放射与免疫系统长期以来的研究历史（图1），似乎是为这种有趣的癌症治疗组合提供背景的恰当做法。
