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立体定向放疗和免疫治疗的远隔效应:愚人金还是黄金国?

The Abscopal Effect of Stereotactic Radiotherapy and Immunotherapy: Fool's Gold or El Dorado?

机构信息

Division of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia.

Division of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia; Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Australia.

出版信息

Clin Oncol (R Coll Radiol). 2019 Jul;31(7):432-443. doi: 10.1016/j.clon.2019.04.006. Epub 2019 Apr 17.

Abstract

An 'abscopal' effect if often used to refer to distant tumour regression after localised irradiation. Since the first report of the abscopal effect in the 1950s, well-documented cases with radiotherapy alone are very rare. It is widely accepted that the immune response plays an important role in the abscopal effect, although the mechanism is still unclear. With the recent success of cancer immunotherapy, there is growing interest in combining immunotherapy with radiotherapy to boost abscopal response rates. Compared with conventional radiotherapy, stereotactic ablative radiotherapy (SABR) not only delivers ablative dose to the tumour, but may also induce robust immune responses. In this review we examine studies that combine SABR and immunotherapy. We review the preclinical rationale for SABR and immunotherapy combinations, the case for and against abscopal effects, and the current landscape of clinical trials.

摘要

“远隔效应”通常用于描述局部照射后远处肿瘤的消退。自 20 世纪 50 年代首次报道远隔效应以来,仅有少数经充分证实的单纯放疗病例。人们普遍认为免疫反应在远隔效应中起重要作用,尽管其机制尚不清楚。随着癌症免疫疗法的近期成功,人们越来越有兴趣将免疫疗法与放疗相结合以提高远隔效应率。与常规放疗相比,立体定向消融放疗(SABR)不仅能将消融剂量传递到肿瘤,还可能诱导强烈的免疫反应。在这篇综述中,我们研究了 SABR 与免疫疗法相结合的研究。我们回顾了 SABR 与免疫疗法联合应用的临床前原理、支持和反对远隔效应的理由,以及目前临床试验的现状。

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