Horwich A
Royal Marsden Hospital, Sutton, Surrey, UK.
Br J Cancer. 1993 Jan;67(1):198-201. doi: 10.1038/bjc.1993.34.
The meeting was reviewed and summarised by Professor Herman Suit. He judged that the potential clinical gains from research in radiobiology were very great and likely to translate to improved cancer treatment in the near future. He was highly complimentary about the contribution of UK research in radiobiology and he indicated that this viewpoint was held widely in the United States, Europe and Japan. Radiobiological research was the basis for major clinical trials in radiotherapy undertaken by trial groups in all these countries. He felt that major contributions to current practice in radiotherapy had been the definition of dose response, the rationale for the use of radiotherapy against slowly responding tumours, and the understanding of repair differentials and of clonal proliferation in the design of clinical fractionation trials, leading to clear demonstration of benefit for altered fractionation in the treatment of head and neck cancer and in the treatment of bladder cancer. An important goal of research should be the development of predictive testing for radiation response employing multiple predictive tests of radiation sensitivity (survival at 2 Gy), cellular proliferation (potential doubling time) and identification of hypoxic cells, together with physiological parameters such as blood flow intratumoral pressure, thiol metabolism and activation and status of repair genes. In terms of improving differential response between tumour and normal tissues, further refinement of dose fractionation patterns would be needed, but also research should continue on the modification of response using drug/radiation protocols, targeting techniques, growth factors and other biological response modifiers to support normal tissues, and modulation of DNA repair. Professor Suit felt that the pace of research in radiobiology was most encouraging for the field of radiotherapy. There was a consensus that support for radiobiology needed to be matched by support for academic radiotherapy if potential research gains were to be translated into advances in treatment. He shared the view expressed by the Committee of Cancer Experts of the EORTC that improvements in cancer cure over the next decade were likely to derive from improvements in radiotherapy.
赫尔曼·休伊特教授对此次会议进行了回顾和总结。他认为，放射生物学研究在临床上的潜在收益非常巨大，很可能在不久的将来转化为癌症治疗的改善。他对英国放射生物学研究的贡献给予了高度赞扬，并表示这种观点在美国、欧洲和日本也得到广泛认同。放射生物学研究是所有这些国家的试验小组在放射治疗方面进行重大临床试验的基础。他觉得，对当前放射治疗实践的主要贡献包括剂量反应的定义、针对反应缓慢的肿瘤使用放射治疗的基本原理，以及在临床分次试验设计中对修复差异和克隆增殖的理解，从而明确证明了改变分次在头颈部癌和膀胱癌治疗中的益处。研究的一个重要目标应该是开发辐射反应预测测试，采用多种辐射敏感性预测测试（2 Gy时的存活率）、细胞增殖（潜在倍增时间）以及缺氧细胞的识别，同时结合生理参数，如肿瘤内血流压力、硫醇代谢以及修复基因的激活和状态。在改善肿瘤组织和正常组织之间的差异反应方面，需要进一步优化剂量分割模式，但也应该继续研究使用药物/放射治疗方案、靶向技术、生长因子和其他生物反应调节剂来调节反应，以支持正常组织，并调节DNA修复。休伊特教授认为，放射生物学的研究步伐对放射治疗领域来说非常鼓舞人心。大家一致认为，如果要将潜在的研究成果转化为治疗进展，对放射生物学的支持需要与对学术放射治疗的支持相匹配。他认同欧洲癌症研究与治疗组织（EORTC）癌症专家委员会表达的观点，即未来十年癌症治愈率的提高可能源于放射治疗的改进。
