He Kewen, Barsoumian Hampartsoum B, Sezen Duygu, Puebla-Osorio Nahum, Hsu Ethan Y, Verma Vivek, Abana Chike O, Chen Dawei, Patel Roshal R, Gu Meidi, Cortez Maria Angelica, Welsh James W
Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States.
Department of Radiation Oncology, Shandong Cancer Hospital Affiliated to Shandong University, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China.
Front Oncol. 2021 Aug 23;11:737425. doi: 10.3389/fonc.2021.737425. eCollection 2021.
Radiation therapy (RT) is emerging as an interventional modality in the cancer-immunity cycle, augmenting the activation of an adaptive immune response against tumors. RT, particularly in combination with immunotherapy, can enhance immune memory effects and shape the tumor-directed T-cell populations. However, a single cycle of RT delivered to a limited number of polymetastatic lesions is rarely sufficient to achieve systemic control. We hypothesize that several rounds of RT, akin to several rounds of immunotherapeutic drugs, is likely to provide greater clinical benefit to patients with metastatic disease. We propose that the repeated exposure to tumor antigens released by "pulsed-RT" (i.e., treating 2-4 tumor lesions with 3 irradiation cycles given one month apart) may amplify the adaptive immune response by expanding the tumor-specific T-cell receptor repertoire, the production of high-affinity tumor antibodies, and the generation of memory lymphocytes and thereby improve immune control of systemic disease.
放射治疗（RT）正在成为癌症免疫循环中的一种介入方式，增强针对肿瘤的适应性免疫反应的激活。RT，特别是与免疫疗法联合使用时，可增强免疫记忆效应并塑造肿瘤导向的T细胞群体。然而，对有限数量的多转移病灶进行单周期RT很少足以实现全身控制。我们假设，类似于多轮免疫治疗药物，多轮RT可能会为转移性疾病患者带来更大的临床益处。我们提出，通过“脉冲RT”（即每隔一个月进行3个照射周期，治疗2-4个肿瘤病灶）释放的肿瘤抗原的反复暴露，可能通过扩大肿瘤特异性T细胞受体库、产生高亲和力肿瘤抗体以及产生记忆淋巴细胞来放大适应性免疫反应，从而改善对全身疾病的免疫控制。
