胸部放疗联合 EGFR －TKIs 致肺纤维化的研究进展  

Advances in pulmonary fibrosis caused by thoracic radiotherapy combined with EGFR-TKIs

作　　者：张倩[1] 乔文波[1] 

机构地区：[1]哈尔滨医科大学附属肿瘤医院放疗科,哈尔滨150081

出　　处：《实用肿瘤学杂志》2015年第2期162-166,共5页Practical Oncology Journal

基　　金：黑龙江省教育厅科学基金项目（11531194）

摘　　要：胸部放射治疗是非小细胞肺癌（Non－small cell lung cancer，NSCLC）局部治疗的重要手段，而表皮生长因子受体酪氨酸激酶抑制剂（ Epidermal growth factor receptor －tyrosine kinase inhibitor ，EGFR－TKIs）具有全身治疗的作用，研究表明EGFR外显子19、21突变阳性的NSCLC患者放疗与EGFR－TKIs联合治疗时具有增效作用。放疗可激活EGFR信号通路，诱导细胞的增殖和DNA损伤修复，从而导致放射抵抗，因此EGFR－TKIs具有增加放疗敏感性的作用。两者联合治疗时最常见的副反应是肺损伤。研究提示放疗联合EGFR－TKIs在肺纤维化发展中具有矛盾作用，这些研究间差异的存在可能是因为实验系统的不同，纤维化模型的差异，以及不同物种和个体间的差异。因此需要对肺纤维化的病因有更完整的理解，以促进治疗进展。Thoracic radiotherapy is an important means of local treatment for non -small cell lung cancer （NSCLC）.Epidermal growth factor receptor tyrosine kinase inhibitors （EGFR-TKIs）have the effect of systemic therapy.Studies have shown that NSCLC patients with EGFR exons 19,21 mutation have a synergistic effect in the combination therapy .Radiotherapy activates EGFR signaling pathway ,inducing cell proliferation and DNA damage repair,leading to radiation resistance .Therefore,EGFR-TKIs have the effect in increasing radiosensitivity .Lung injury is one of the most common side effects when the two therapies combined .Studies suggest that radiotherapy combined with EGFR-TKIs may have conflicting functions in the development of pulmonary fibrosis ,the discrep-ancy between these studies may depend on the differences in the experimental systems ,the differences in pulmo-nary fibrosis models,as well as the differences between different species and individuals .Therefore,a more com-plete understanding of the etiology for pulmonary fibrosis is necessary to the development of improved treatments .

关 键 词：胸部放射治疗 EGFR-TKIS 肺纤维化 

分 类 号：R734.2[医药卫生—肿瘤]