Lei Haoran, Shi Ming, Xu Hang, Bai Shengjiang, Xiong Xingyu, Wei Qiang, Yang Lu
Department of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China.
Cancer Manag Res. 2021 Feb 24;13:1719-1731. doi: 10.2147/CMAR.S288337. eCollection 2021.
Although it has always been believed that radiation has immunosuppressive effects, more and more preclinical and clinical trials have shown that the combination of radiotherapy and immunotherapy has a potential synergistic effect to treat cancers including urological malignancies. When radiotherapy is combined with immunotherapy, improved prognosis has been observed in different urinary tumors. However, there is no standard treatment, such as the optimal dose/fractionation and the sequence of immunotherapy and radiotherapy. In this review, we discussed the effects of radiotherapy on the cancer immune system and emphasized the synergy of radiotherapy combined with immunotherapy. Although it has significantly improved the prognosis of tumors, there are still some unresolved questions about how to best use this combination in clinical practice. Ongoing trials will provide further information on the interaction of radiotherapy combined with immunotherapy, and are expected to guide clinical practice and improve clinical outcomes.
尽管一直以来人们都认为辐射具有免疫抑制作用,但越来越多的临床前和临床试验表明,放射治疗与免疫治疗联合应用对包括泌尿生殖系统恶性肿瘤在内的癌症具有潜在的协同治疗效果。当放射治疗与免疫治疗联合使用时,在不同的泌尿系统肿瘤中均观察到预后得到改善。然而,目前尚无标准的治疗方案,例如免疫治疗和放射治疗的最佳剂量/分割方式以及联合顺序。在本综述中,我们讨论了放射治疗对癌症免疫系统的影响,并强调了放射治疗与免疫治疗联合应用的协同作用。尽管这一联合治疗显著改善了肿瘤的预后,但在临床实践中如何最佳地应用这种联合治疗仍存在一些未解决的问题。正在进行的试验将提供有关放射治疗与免疫治疗联合应用相互作用的更多信息,有望指导临床实践并改善临床疗效。