Systemic effects of local radiotherapy.
Systemic effects of local radiotherapy.
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DOI：
10.1016/s1470-2045(09)70082-8
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发表时间：
2009-07
期刊：
影响因子：
51.1
通讯作者：
Demaria, Sandra
中科院分区：
文献类型：
--
作者：
Formenti, Silvia C.;Demaria, Sandra
放射疗法通常用于治疗包括癌症在内的局部靶标。越来越多的证据表明，放疗还会招募治疗范围之外的生物效应器，并产生全身效应。本综述在了解宿主免疫系统在与标准细胞毒性治疗配合中的作用的背景下讨论了这方面的含义。由于免疫系统可以感知化疗和放疗的效果，因此它们与免疫疗法的结合提供了新的治疗机会。放射治疗的优点是直接干扰原发肿瘤部位，并有可能恢复肿瘤微环境中存在的一些已建立的免疫抑制屏障，理想地恢复原发肿瘤作为有效免疫原性中心的作用。局部辐射还会引发全身效应，可以与免疫疗法结合使用，以诱导辐射场外的反应。本综述将涵盖这方面的一些临床前和临床证据。
Radiotherapy is generally used to treat a localized target that includes cancer. Mounting evidence indicates that radiotherapy also recruits biological effectors outside the treatment field, and has systemic effects. The implications of this aspect are discussed in this review, in the context of understanding the role of the host’s immune system in cooperating with standard cytotoxic treatments. Since effects from both chemotherapy and radiotherapy are sensed by the immune system, their combination with immunotherapy presents a new therapeutic opportunity. Radiotherapy carries the advantage of directly interfering with the primary tumor site, and potentially reverting some of the established immuno-supressive barriers present within the tumor microenvironment, ideally recovering the role of the primary tumor as an effective immunogenic hub. Local radiation also triggers systemic effects that can be harnessed in combination with immunotherapy to induce responses outside the radiation field. This review will cover some of the preclinical and clinical evidence in this regard.