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鼻咽癌的放化疗联合治疗。

Combinations of radiotherapy with immunotherapy in nasopharyngeal carcinoma.

机构信息

Department of Radiation Oncology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.

Department of Orthopedics, Shanghai Pudong Hospital, Fudan University, Pudong Medical Center, Shanghai, China.

出版信息

Int Immunopharmacol. 2023 Dec;125(Pt A):111094. doi: 10.1016/j.intimp.2023.111094. Epub 2023 Oct 23.

Abstract

BACKGROUND

The treatment of nasopharyngeal carcinoma (NPC) is currently based on concurrent chemoradiotherapy. The prognosis of early NPC is better, while the prognosis of advanced NPC is poor. Immunotherapy is becoming increasingly commonly employed in clinical practice as a new strategy for treating malignant tumors. It has shown promising results in the treatment of certain malignant tumors, making it a current clinical research hotspot.

METHODS

This review summarizes the current immunotherapy on NPC, highlighting the application of immunotherapy and radiotherapy in the treatment of NPC.

RESULTS

X-rays can either increase or suppress anti-tumor immune responses through various pathways and mechanisms. Immune checkpoint inhibitors can usually enhance X-ray-induced anti-tumor immune responses. Detecting the immune checkpoint markers and tumor mutation markers, and the functional status of effector cells in patients can aid in the development of individualized treatment that improves the treatment efficacy with reducing drug resistance and adverse reactions. The development of a multivalent vaccine for NPC will help improve the efficacy of the vaccine. Combining techniques that increase the tumor antigens release, such as radiotherapy and oncolytic virus vaccines, may enhance the ability of the immune response.

CONCLUSIONS

To shed further light on the application of immunotherapy in NPC, large pooled studies must accumulate sufficient cases with detailed exposure data.

摘要

背景

目前鼻咽癌(NPC)的治疗主要基于同期放化疗。早期 NPC 的预后较好,而晚期 NPC 的预后较差。免疫疗法作为治疗恶性肿瘤的一种新策略,在临床实践中越来越多地被采用。它在治疗某些恶性肿瘤方面显示出了良好的效果,成为当前临床研究的热点。

方法

本综述总结了目前 NPC 的免疫治疗,强调了免疫疗法和放疗在 NPC 治疗中的应用。

结果

X 射线可以通过多种途径和机制增加或抑制抗肿瘤免疫反应。免疫检查点抑制剂通常可以增强 X 射线诱导的抗肿瘤免疫反应。检测患者的免疫检查点标志物和肿瘤突变标志物,以及效应细胞的功能状态,可以帮助制定个体化治疗方案,提高治疗效果,减少耐药性和不良反应。开发用于 NPC 的多价疫苗将有助于提高疫苗的疗效。结合增加肿瘤抗原释放的技术,如放疗和溶瘤病毒疫苗,可能会增强免疫反应的能力。

结论

为了进一步阐明免疫疗法在 NPC 中的应用,必须积累足够的病例并积累详细的暴露数据。

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