Linares-Galiana Isabel, Berenguer-Frances Miguel Angel, Cañas-Cortés Rut, Pujol-Canadell Monica, Comas-Antón Silvia, Martínez Evelyn, Laplana Maria, Pérez-Montero Héctor, Pla-Farnós María Jesús, Navarro-Martin Arturo, Nuñez Miriam, Both Brigitte, Guedea Ferran
Radiation Oncology Department, Hospital Duran i Reynals, Institut Català d'Oncologia (ICO), Avinguda de la Gran Via de l'Hospitalet 199-203, L'Hospitalet de Llobregat, 08098 Barcelona, Spain.
Radiobiology and Cancer Group, ONCOBELL Program, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Avinguda de la Gran Via de l'Hospitalet 199-203, L'Hospitalet de Llobregat, 08098 Barcelona, Spain.
J Radiat Res. 2021 Jan 1;62(1):110-118. doi: 10.1093/jrr/rraa083.
A detailed understanding of the interactions and the best dose-fractionation scheme of radiation to maximize antitumor immunity have not been fully established. In this study, the effect on the host immune system of a single dose of 20 Gy through intraoperative radiation therapy (IORT) on the surgical bed in low-risk breast cancer patients undergoing conserving breast cancer has been assessed. Peripheral blood samples from 13 patients were collected preoperatively and at 48 h and 3 and 10 weeks after the administration of radiation. We performed a flow cytometry analysis for lymphocyte subpopulations, natural killer cells (NK), regulatory T cells (Treg) and myeloid-derived suppressor cells (MDSCs). We observed that the subpopulation of NK CD56+high CD16+ increased significantly at 3 weeks after IORT (0.30-0.42%, P < 0.001), while no changes were found in immunosuppressive profile, CD4+CD25+Foxp3+Helios+ Treg cells, granulocytic MDSCs (G-MDSCs) and monocytic MDSCs (Mo-MDSCs). A single dose of IORT may be an effective approach to improve antitumor immunity based on the increase in NK cells and the non-stimulation of immunosuppressive cells involved in immune escape. These findings support future combinations of IORT with immunotherapy, if they are confirmed in a large cohort of breast cancer patients.
对于辐射的相互作用以及最佳剂量分割方案以最大限度地提高抗肿瘤免疫力，尚未完全建立详细的了解。在本研究中，评估了在接受保乳手术的低风险乳腺癌患者中，通过术中放疗（IORT）在手术床上单次给予20 Gy辐射对宿主免疫系统的影响。收集了13例患者术前以及放疗后48小时、3周和10周的外周血样本。我们对淋巴细胞亚群、自然杀伤细胞（NK）、调节性T细胞（Treg）和髓源性抑制细胞（MDSC）进行了流式细胞术分析。我们观察到，IORT后3周时，NK CD56+高CD16+亚群显著增加（从0.30%增至0.42%，P < 0.001）），而免疫抑制谱、CD4+CD25+Foxp3+Helios+ Treg细胞、粒细胞MDSC（G-MDSC）和单核细胞MDSC（Mo-MDSC）均未发现变化。基于NK细胞增加且未刺激参与免疫逃逸的免疫抑制细胞，单次IORT剂量可能是提高抗肿瘤免疫力的有效方法。如果在大量乳腺癌患者队列中得到证实，这些发现支持IORT与免疫疗法未来的联合应用。
