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癌症患者放疗后的远隔效应:从免疫学角度的新审视

Abscopal Effect Following Radiation Therapy in Cancer Patients: A New Look from the Immunological Point of View.

作者信息

J Welsh, J J Bevelacqua, L Dobrzyński, S A R Mortazavi, Sh Farjadian, S M J Mortazavi

机构信息

MD, PhD, Department of Radiation Oncology, Edward Hines Jr VA Hospital, Hines, IL 60141, United States.

PhD, Bevelacqua Resources, Richland, Washington 99352, United States.

出版信息

J Biomed Phys Eng. 2020 Aug 1;10(4):537-542. doi: 10.31661/jbpe.v0i0.1066. eCollection 2020 Aug.

Abstract

Abscopal effect, a radiobiology term meaning "away from target", was practically unheard of just ten years ago. This effect describes the elimination and cure of a non-treated tumor when another part of the body is irradiated. Successful treatment of cancer in patients with multiple metastatic foci has sporadically been reported. Abscopal effect after radiotherapy has been introduced as the key factor which induced an anticancer response in these metastatic lesions. Moreover, not receiving chemotherapy is reported to have a role in cancer regression after radiotherapy. Given this consideration, it can be hypothesized that standard radiotherapy doses, which usually classified as high-dose, may cause cancer cells to expose or release their sequestered antigens that had been previously masked. Furthermore, radiotherapy can decrease the suppressive effect of regulatory T cells which usually down modulate immune responses against cancers. Moreover, some data show that low dose total-body irradiation (TBI) alone (without standard localized high dose radiotherapy) may cause suppression of distant metastasis of tumor cells. Induction of a "whole body abscopal effect" can be involved in suppression of distant metastasis. Here we discuss whether cancer treatments could be more successful if immune system is boosted, not destroyed by the treatments such as chemotherapy.

摘要

远隔效应是一个放射生物学术语,意为“远离靶区”,就在十年前实际上还闻所未闻。这种效应描述的是当身体的另一部位受到照射时,未接受治疗的肿瘤被消除和治愈的情况。已有零星报道称成功治疗了具有多个转移灶的癌症患者。放疗后的远隔效应已被视为在这些转移病灶中引发抗癌反应的关键因素。此外,据报道未接受化疗在放疗后癌症消退中起作用。基于此,可以推测通常归类为高剂量的标准放疗剂量可能会使癌细胞暴露或释放其先前被掩盖的隔离抗原。此外,放疗可以降低调节性T细胞的抑制作用,而调节性T细胞通常会下调针对癌症的免疫反应。此外,一些数据表明,单独的低剂量全身照射(TBI)(无标准的局部高剂量放疗)可能会抑制肿瘤细胞的远处转移。诱导“全身远隔效应”可能参与抑制远处转移。在此,我们讨论如果免疫系统得到增强而非像化疗等治疗手段那样被破坏,癌症治疗是否会更成功。

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