Department of Radiation Oncology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA 19107, USA.
Department of Integrative Medicine and Nutritional Sciences, Marcus Institute of Integrative Health, Thomas Jefferson University, Philadelphia, PA 19107, USA.
Int J Mol Sci. 2021 Dec 24;23(1):175. doi: 10.3390/ijms23010175.
Understanding metabolic and immune regulation inherent to patient populations is key to improving the radiation response for our patients. To date, radiation therapy regimens are prescribed based on tumor type and stage. Patient populations who are noted to have a poor response to radiation such as those of African American descent, those who have obesity or metabolic syndrome, or senior adult oncology patients, should be considered for concurrent therapies with radiation that will improve response. Here, we explore these populations of breast cancer patients, who frequently display radiation resistance and increased mortality rates, and identify the molecular underpinnings that are, in part, responsible for the radiation response and that result in an immune-suppressive tumor microenvironment. The resulting immune phenotype is discussed to understand how antitumor immunity could be improved. Correcting nutrient deficiencies observed in these populations should be considered as a means to improve the therapeutic index of radiation therapy.
了解患者群体固有的代谢和免疫调节是改善患者放射反应的关键。迄今为止，放射治疗方案是根据肿瘤类型和分期来制定的。对于那些被认为对辐射反应不佳的患者群体，如非裔美国人、肥胖或代谢综合征患者，或老年肿瘤患者，应考虑同时进行放射治疗，以提高疗效。在这里，我们探讨了这些乳腺癌患者群体，她们经常表现出辐射抵抗和更高的死亡率，并确定了部分导致辐射反应和免疫抑制肿瘤微环境的分子基础。讨论了由此产生的免疫表型，以了解如何改善抗肿瘤免疫力。应考虑纠正这些人群中观察到的营养缺乏，以提高放射治疗的治疗指数。
