Biological predictors of response to radiotherapy in head and neck cancer:: Recent advances and emerging perspectives
Biological predictors of response to radiotherapy in head and neck cancer:: Recent advances and emerging perspectives
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DOI：
10.1177/030089160108700601
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发表时间：
2001-11-01
期刊：
影响因子：
1.9
通讯作者：
Sanguineti, G
中科院分区：
文献类型：
--
作者：
Corvò, R;Antognoni, P;Sanguineti, G
在过去的十年里，新的生物学参数的研究在放射治疗中受到了极大的关注，因为它们在预测头颈部鳞状细胞癌(SCC-HN)的治疗反应方面具有潜在的价值，并且可以预见到为个体患者选择改变的分割放射治疗的可能性。虽然SCC-HN患者的临床参数与辐射反应(疾病程度、血红蛋白水平)有关，但最近在直接测量肿瘤氧合、固有的放射敏感性和增殖率方面的进展增加了根据这些放射生物学参数制定个体化治疗策略的希望。分子生物学研究已经发现了一系列具有潜在预测作用的新的生物学参数，癌基因、肿瘤抑制基因、细胞周期调控基因、细胞凋亡基因和血管生成基因已被广泛研究并与辐射反应相关。此外，对表皮生长因子受体信号转导系统作为可能的反应调节器的研究，最近促进了利用阻断该受体来下调肿瘤生长的分子策略。本文简要回顾和分析了阻碍生物学参数用于预测肿瘤放射治疗反应的主要争议问题和缺陷。它强调了放射治疗预测分析研究的未来前景，以及从单参数分析转向多参数研究的必要性，多参数研究考虑了共同参与不同生物学和临床途径的几个潜在预测因素。
The study of new biological parameters has received considerable attention in radiotherapy during the last decade due to their potential value in predicting treatment response in squamous cell carcinoma of the head and neck (SCC-HN) and the foreseen possibility of selecting altered fractionation radiotherapy for the individual patient. Although there are established clinical parameters in SCC-HN patients that relate to radiation response (extent of disease, hemoglobin level), recent advances with direct measurement of tumor oxygenation, inherent radiosensitivity and proliferation rate have increased the promise of individualization of treatment strategy according to these radiobiologically based parameters. Molecular research has now identified a host of new biological parameters with potential predictive utility; oncogenes, tumor suppressor genes, cell-cycle control genes, apoptosis genes and angiogenesis genes have been extensively studied and correlated with radiation response. Moreover, study of the epidermal growth factor receptor signal-transduction system as a possible response modulator has recently fostered molecular strategies which employ blockade of the receptor to down-regulate tumor growth. This article briefly reviews and analyzes the main controversial issues and drawbacks that hinder the general use of biological parameters for predicting tumor response to radiotherapy. It highlights the future perspectives of radiotherapy predictive assay research and the need to shift from single-parameter analysis to multiparametric studies which take into account several potential predictors that together are involved in different biological and clinical pathways.