Sorolla Maria Alba, Parisi Eva, Sorolla Anabel
Research Group of Cancer Biomarkers, Biomedical Research Institute (IRB Lleida), 25198 Lleida, Spain.
Harry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands and Centre for Medical Research, The University of Western Australia, Crawley, Western Australia 6009, Australia.
Cancers (Basel). 2020 Jul 15;12(7):1906. doi: 10.3390/cancers12071906.
Radiotherapy is one of the cornerstone treatments for endometrial cancer and has successfully diminished the risk of local recurrences after surgery. However, a considerable percentage of patients suffers tumor relapse due to radioresistance mechanisms. Knowledge about the molecular determinants that confer radioresistance or radiosensitivity in endometrial cancer is still partial, as opposed to other cancers. In this review, we have highlighted different central cellular signaling pathways and processes that are known to modulate response to radiotherapy in endometrial cancer such as PI3K/AKT, MAPK and NF-κB pathways, growth factor receptor signaling, DNA damage repair mechanisms and the immune system. Moreover, we have listed different clinical trials employing targeted therapies against some of the aforementioned signaling pathways and members with radiotherapy. Finally, we have identified the latest advances in radiotherapy that have started being utilized in endometrial cancer, which include modern radiotherapy and radiogenomics. New molecular and genetic studies in association with the analysis of radiation responses in endometrial cancer will assist clinicians in taking suitable decisions for each individual patient and pave the path for personalized radiotherapy.
放射治疗是子宫内膜癌的基石治疗方法之一，已成功降低了手术后局部复发的风险。然而，相当一部分患者由于放射抵抗机制而出现肿瘤复发。与其他癌症不同，关于子宫内膜癌中赋予放射抵抗或放射敏感性的分子决定因素的认识仍然不全面。在本综述中，我们重点介绍了已知可调节子宫内膜癌对放射治疗反应的不同核心细胞信号通路和过程，如PI3K/AKT、MAPK和NF-κB通路、生长因子受体信号传导、DNA损伤修复机制和免疫系统。此外，我们列出了针对上述一些信号通路和成员采用靶向治疗联合放射治疗的不同临床试验。最后，我们确定了已开始应用于子宫内膜癌的放射治疗的最新进展，包括现代放射治疗和放射基因组学。与子宫内膜癌放射反应分析相关的新的分子和遗传学研究将帮助临床医生为每个患者做出合适的决策，并为个性化放射治疗铺平道路。
