Princess Margaret Cancer Center, University Health Network, Toronto, Canada; Department of Medical Biophysics, University of Toronto, Toronto, Canada.
Princess Margaret Cancer Center, University Health Network, Toronto, Canada; Department of Medical Biophysics, University of Toronto, Toronto, Canada; Department of Radiation Oncology, University of Toronto, Toronto, Canada.
Radiother Oncol. 2017 Sep;124(3):357-364. doi: 10.1016/j.radonc.2017.07.004. Epub 2017 Jul 20.
Emerging technologies for detection of circulating tumour DNA (ctDNA) are expanding the possibilities for clinical impact to patients with localized, potentially curable cancer. For such patients, ctDNA analysis could aid in prognostication, prediction of treatment response, longitudinal monitoring for adaptive treatment, and evaluation of minimal residual disease. Radiation oncologists currently have few tools at their disposal for predicting or rapidly assessing treatment efficacy. By reflecting the genetic and epigenetic makeup of tumours as well as dynamic changes with treatment, ctDNA as a biomarker for radiation response could enable new personalized treatment approaches. In this review, we will discuss recent advances in ctDNA technologies and potential clinical applications of ctDNA analysis throughout the therapeutic course. Furthermore, we will consider how ctDNA analysis could someday guide radiotherapy prescriptions by revealing differences in tumour radiophenotype.
新兴的循环肿瘤 DNA（ctDNA）检测技术正在为局部、潜在可治愈的癌症患者的临床治疗带来更多可能。对于这些患者，ctDNA 分析可辅助预后判断、治疗反应预测、适应性治疗的纵向监测和微小残留病灶的评估。放射肿瘤学家目前可用于预测或快速评估治疗效果的工具很少。ctDNA 作为一种辐射反应的生物标志物，通过反映肿瘤的遗传和表观遗传组成以及治疗过程中的动态变化，为新的个性化治疗方法提供了可能。在这篇综述中，我们将讨论 ctDNA 技术的最新进展以及在整个治疗过程中 ctDNA 分析的潜在临床应用。此外，我们还将探讨 ctDNA 分析如何通过揭示肿瘤放射表型的差异来指导放射治疗处方。
