Translational Hematology and Oncology Research Department, Lerner Research Institute, Cleveland Clinic Foundation, Cleveland,OH; Systems Biology and Bioinformatics Program, School of Medicine, Case Western Reserve University, Cleveland, OH.
Translational Hematology and Oncology Research Department, Lerner Research Institute, Cleveland Clinic Foundation, Cleveland,OH; Radiation Oncology Department, Taussig Cancer Institute, Cleveland Clinic Foundation, 10201 Carnegie Ave, Cleveland, OH.
Semin Radiat Oncol. 2022 Jan;32(1):42-53. doi: 10.1016/j.semradonc.2021.09.001.
The reach of personalized medicine in radiation oncology has expanded greatly over the past few decades as technical precision has improved the delivery of radiation to each patient's unique anatomy. Yet, the consideration of biological heterogeneity between patients has largely not been translated to clinical care. There are innumerable promising advancements in the discovery and validation of biomarkers, which could be used to alter radiation therapy directly or indirectly. Directly, biomarker-informed care may alter treatment dose or identify patients who would benefit most from radiation therapy and who could safely avoid more aggressive care. Indirectly, a variety of biomarkers could assist with choosing the best radiosensitizing chemotherapies. The translation of these advancements into clinical practice will bring radiation oncology even further into the era of precision medicine, treating patients according to their unique anatomical and biological differences.
在过去的几十年中,随着技术精度的提高,个性化医学在放射肿瘤学中的应用范围大大扩大,能够将放射治疗精确地应用于每个患者独特的解剖结构。然而,患者之间生物学异质性的考虑在很大程度上尚未转化为临床护理。在发现和验证生物标志物方面有无数有前途的进展,这些标志物可以直接或间接地用于改变放射治疗。直接地,基于生物标志物的治疗可以改变治疗剂量,或者确定最受益于放射治疗的患者,以及能够安全避免更激进治疗的患者。间接地,各种生物标志物可以帮助选择最佳的增敏化疗药物。将这些进展转化为临床实践,将使放射肿瘤学进一步进入精准医学时代,根据患者独特的解剖学和生物学差异进行治疗。