Nesseler J P, Peiffert D, Vogin G, Nickers P
Département de radiothérapie, institut de cancérologie de Lorraine, 6, avenue de Bourgogne, 54519 Vandœuvre-lès-Nancy, France.
Département de radiothérapie, institut de cancérologie de Lorraine, 6, avenue de Bourgogne, 54519 Vandœuvre-lès-Nancy, France.
Cancer Radiother. 2017 Jun;21(4):307-315. doi: 10.1016/j.canrad.2017.02.002. Epub 2017 May 10.
Novel paradigms emerge in oncology today. Systemic treatments are more effective and diversified along with an increased life expectancy in oligometastatic patients. Stereotactic radiotherapy using hypofractionation opens new perspectives for local tumour control. The area of radiobiology has expanded with integration of tumour microenvironment in which radiation-induced inflammation mediators and immune system play a major role. Immunity checkpoints inhibitors experience a major development. This rapidly evolving field seems involved in the abscopal effects, especially when radiation is combined with checkpoints inhibitors, as demonstrated in numerous preclinical studies and several clinical trials. Paradoxically, irradiation also produces immunosuppressive effects. This manuscript aims to report the dual effects of ionizing radiation on the immune system and reviews some results of the combination of radiation and immunity chekpoints inhibitors and also research perspectives.
如今肿瘤学领域出现了新的模式。随着寡转移患者预期寿命的增加,全身治疗更加有效且多样化。采用大分割的立体定向放射治疗为局部肿瘤控制开辟了新的前景。放射生物学领域随着肿瘤微环境的整合而扩展,其中辐射诱导的炎症介质和免疫系统发挥着主要作用。免疫检查点抑制剂取得了重大进展。这个快速发展的领域似乎与远隔效应有关,特别是当放疗与检查点抑制剂联合使用时,众多临床前研究和一些临床试验都证明了这一点。矛盾的是,辐射也会产生免疫抑制作用。本文旨在报告电离辐射对免疫系统的双重作用,并综述放疗与免疫检查点抑制剂联合使用的一些结果以及研究前景。