Department of Radiation Oncology, Dana-Farber Cancer Institute, Brigham and Women's Hospital and Harvard Medical School, 450 Brookline Avenue, Boston, MA, USA.
University Medical Center Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3. D-68167, Mannheim, Germany.
Nat Rev Cancer. 2018 May;18(5):313-322. doi: 10.1038/nrc.2018.6. Epub 2018 Feb 16.
More than 60 years ago, the effect whereby radiotherapy at one site may lead to regression of metastatic cancer at distant sites that are not irradiated was described and called the abscopal effect (from 'ab scopus', that is, away from the target). The abscopal effect has been connected to mechanisms involving the immune system. However, the effect is rare because at the time of treatment, established immune-tolerance mechanisms may hamper the development of sufficiently robust abscopal responses. Today, the growing consensus is that combining radiotherapy with immunotherapy provides an opportunity to boost abscopal response rates, extending the use of radiotherapy to treatment of both local and metastatic disease. In this Opinion article, we review evidence for this growing consensus and highlight emerging limitations to boosting the abscopal effect using immunotherapy. This is followed by a perspective on current and potential cross-disciplinary approaches, including the use of smart materials to address these limitations.
60 多年前，人们描述了一种现象，即放射治疗一个部位可能导致未接受照射的远处转移癌消退，这种现象被称为远隔效应（源自“ab scopus”，即远离目标）。远隔效应与免疫系统有关。然而，由于在治疗时，已建立的免疫耐受机制可能会阻碍足够强大的远隔效应的发展，因此这种效应很少见。如今，越来越多的共识认为，将放射治疗与免疫疗法相结合为提高远隔效应提供了机会，将放射治疗的应用扩展到局部和转移性疾病的治疗。在这篇观点文章中，我们回顾了这一共识的证据，并强调了使用免疫疗法增强远隔效应所面临的新出现的限制。接下来是对当前和潜在的跨学科方法的展望，包括使用智能材料来解决这些限制。
