IRCM, Institut de Recherche en Cancérologie de Montpellier, INSERM U1194, Université de Montpellier, Institut régional du Cancer de Montpellier, Montpellier, France.
Cancer Mechanisms and Biomarkers Group, Radiation Effects Department, Centre for Radiation, Chemical & Environmental Hazards Public Health England Chilton, Didcot, United Kingdom.
Front Immunol. 2021 May 17;12:680503. doi: 10.3389/fimmu.2021.680503. eCollection 2021.
In the past decade, radiation therapy (RT) entered the era of personalized medicine, following the striking improvements in radiation delivery and treatment planning optimization, and in the understanding of the cancer response, including the immunological response. The next challenge is to identify the optimal radiation regimen(s) to induce a clinically relevant anti-tumor immunity response. Organs at risks and the tumor microenvironment (e.g. endothelial cells, macrophages and fibroblasts) often limit the radiation regimen effects due to adverse toxicities. Here, we reviewed how RT can modulate the immune response involved in the tumor control and side effects associated with inflammatory processes. Moreover, we discussed the versatile roles of tumor microenvironment components during RT, how the innate immune sensing of RT-induced genotoxicity, through the cGAS-STING pathway, might link the anti-tumor immune response, radiation-induced necrosis and radiation-induced fibrosis, and how a better understanding of the switch between favorable and deleterious events might help to define innovative approaches to increase RT benefits in patients with cancer.
在过去的十年中，放射治疗（RT）随着放射治疗的显著改善，以及对癌症反应（包括免疫反应）的理解，进入了个性化医疗的时代。下一个挑战是确定最佳的放射治疗方案，以诱导临床相关的抗肿瘤免疫反应。由于不良反应，危险器官和肿瘤微环境（如内皮细胞、巨噬细胞和成纤维细胞）常常限制放射治疗方案的效果。在这里，我们回顾了 RT 如何调节与肿瘤控制和炎症过程相关的副作用相关的免疫反应。此外，我们还讨论了肿瘤微环境成分在 RT 期间的多种作用，通过 cGAS-STING 途径，先天免疫如何感知 RT 诱导的遗传毒性，可能将抗肿瘤免疫反应、放射诱导的坏死和放射诱导的纤维化联系起来，以及更好地理解有利和有害事件之间的转变如何帮助确定增加癌症患者 RT 益处的创新方法。
