放疗过程中肿瘤再增殖及检测研究进展  

Research progress of tumor repopulation during radiotherapy and detection

作　　者：杨佳[1,2] 王真真[3] 岳金波[2] 于金明[2] 

机构地区：[1]济南大学.山东省医学科学院医学与生命科学学院,山东济南250000 [2]山东省肿瘤医院放疗科,山东济南250117 [3]山东省医学科学院附属医院人事科,山东济南250013

出　　处：《中华肿瘤防治杂志》2014年第4期316-320,共5页Chinese Journal of Cancer Prevention and Treatment

基　　金：国家自然科学基金-青年基金(81101700/H1610)

摘　　要：目的:总结放疗过程中肿瘤再增殖及检测的研究进展。方法:应用PubMed、西文生物医学期刊文献数据库及CNKI期刊全文数据库检索系统,以"放射治疗、肿瘤再增殖、发生机制和检测"等为关键词,检索1988-01-2013-02有关放疗过程中肿瘤再增殖的相关文献。纳入标准:1)放疗过程中肿瘤再增殖的发现和论证;2)放疗过程中肿瘤再增殖的机制;3)放疗过程中肿瘤再增殖的检测。根据纳入标准符合分析的文献37篇。结果:常规分割放疗过程中肿瘤再增殖是从临床观察到肿瘤因治疗时间延长导致局部控制率下降而发现,随后通过一系列动物模型,改变分割剂量和分割模式来设定不同长短总的治疗时间,研究肿瘤增殖指标变化来论证。关于分次放疗引起肿瘤再增殖的机制目前尚不清楚,包括细胞丢失减少学说、自身差异修复学说和再氧合学说。目前检测肿瘤再增殖的方法包括传统检测肿瘤局部控制率、50%肿瘤控制剂量、肿瘤倍增时间和免疫组化检测病理增殖指标Ki-67以及新型无创定量功能影像检测。结论:放疗期间肿瘤细胞再增殖是导致放疗抵抗,引起治疗失败的一个重要原因。分次放疗期间肿瘤再增殖机制是复杂的,有待进一步研究。18F-FLT PET等非创伤性功能影像学检查方法,克服了病理方法和传统影像学检查的不足,可以无创、定量地在分子水平观察肿瘤增殖情况,其能否检测放疗过程中肿瘤再增殖需要进一步动物和人体验证。OBJECTIVE：To summarize the progress of research on tumor repopulation during fractionated radiother apy. METHODS： With ＂tumor repopulation＂,＂radiotherapy＂,＂mechanism＂and ＂detection＂ as the key words, the literature was searched in PUBMED,Foreign Medical Journal database and CNKI database searching system, between 1988-01 and 2013-02. The inclusion criteria： 1） The demonstration of tumor repopulation during radiotherapy. 2） The mechanism of tumor repopulation during radiotherapy. 3） The detection of tumor repopulation during radiotherapy. According to the in clusion criteria,37 papers were selected and analyzed. RESULTS： The phenomenon of tumor repopulation during conven tional fractionated radiotherapy usually is found from clinical observations that local control rate decrease with prolonged treatment,then demonstrated by changing the fractionated dose and mode to set different length of overall treatment time and study the change of tumor proliferation index in a series of animal models. However,the mechanism of tumor repopu lation is not well understood. Detecting methods include conventional detection of tumor local control rate, 50% tumor control dose,tumor doubling time and immunohistochemistry detection of pathological proliferation parameters as well as novel non-invasive, quantitative functional imaging detection. CONCLUSIONS： Tumor repopulation during radiotherapy can lead to radioresistance and that is an important cause for local failure. The mechanism of tumor repopulation duringfraetionated radiotherapy is complicated and needs further study. The non-invasive functional imaging methods such as 18 F-FLT PET, can overcome the lack of pathological methods and traditional imaging and can non-invasively, quantitatively observe tumor proliferation at molecular level. However,its ability to detect tumor repopulation during radiotherapy needs further animal and human test validation.

关 键 词：放射疗法 肿瘤再增殖 发生机制 功能影像 综述文献 

分 类 号：R730.55[医药卫生—肿瘤]