恶性肿瘤冷冻治疗的远隔效应  

Abscopal effects of cryotherapy for malignant tumors

作　　者：吴彦妮 罗晨辉 WU Yan-ni;LUO Chen-hui(School of Pharmaceutical Science,University of South China,Hengyang421001,China;Scientific Research Office,Hunan Cancer Hospital,Changsha410013,China)

机构地区：[1]南华大学药学院,湖南衡阳421001 [2]湖南省肿瘤医院科研办,湖南长沙410013

出　　处：《中华肿瘤防治杂志》2022年第22期1636-1640,共5页Chinese Journal of Cancer Prevention and Treatment

基　　金：湖南省临床医疗技术创新引导项目(2018SK50907);长沙市科技局基础研究项目(kq1907126);湖南省自然科学基金面上项目(2021JJ30428);湖南省肿瘤医院科研攀登计划重点研发项目(YF2020011)。

摘　　要：目的对冷冻治疗相关研究进行综述,旨在推进远隔效应的研究。方法以“冷冻治疗肿瘤产生的远隔效应”为主题,在PubMed和中国知网以“冷冻治疗”“冷冻消融”“氩氦刀”“肿瘤治疗”“远隔效应”“联合治疗”为中文关键词,以“cryoablation”“argon-helium cryosurgery”“tumor treat ment”“abscopal effect”“combined treatment”“cryotherapy”为英文关键词,检索1970-2022年相关文献。纳入标准:在恶性肿瘤治疗中应用冷冻治疗;排除标准:内容重复的文献、综述文献和与本研究关联性较小的文献。最终纳入40篇文献。结果冷冻治疗通过超低温气体对肿瘤组织的消融作用,能够使肿瘤细胞坏死和凋亡,调节免疫效应,增强或抑制抗肿瘤免疫反应,但其机制尚未明确。在前列腺癌、乳腺癌和黑色素瘤等恶性肿瘤治疗中,一些患者接受冷冻治疗后,抗肿瘤反应增强,同时出现远处肿瘤消退的现象,类似放射治疗中的“远隔效应”,并且在一些动物实验中也观察到相同的结果。关于冷冻治疗中远隔效应的研究仍然存在争议,但部分未能观察到远隔效应的研究也明确了冷冻治疗在恶性肿瘤治疗中的有效性。目前,恶性肿瘤患者应用冷冻联合免疫治疗疗效较好,联合疗法也正在动物实验中开展。结论冷冻治疗在恶性肿瘤治疗中产生远隔效应的机制仍需进一步研究,临床上开展冷冻治疗与免疫治疗的联合应用将会推进恶性肿瘤治疗新模式的开发。Objective To review the abscopal effect of cryotherapy on malignant tumors and gives examples of cryotherapy combined with immunotherapy,hoping to promote the study of abscopal effect.Methods Taking"the abscopal effect of cryotherapy on tumor"as the theme and"cryotherapy""cryoablation""argon-helium cryosurgery""tumor treatment""abscopal effect"and"combined treatment"as keywords,we searched the relevant documents in PubMed,Chinese National Knowledge Infrastructure(CNKI)from 1970 to 2022.Inclusion criteria included cryotherapy applied in the treatment of malignant tumors.Exclusion criteria included repeated content article,review and article published with low relevance to this study.A total of 40 documents were retrieved.Results Cryotherapy is capable of causing necrosis and apoptosis of tumor cells through the ablation of tumor tissue by ultra-low temperatures.Cryotherapy may result in enhanced or suppressed anti-tumor immune responses through modulation of immune effects,but the mechanism involved is not yet clear.In the treatment of malignant tumors such as prostate cancer,breast cancer and melanoma,some patients have enhanced anti-tumor response after cryotherapy,while the phenomenon of distant tumor regression occurs,similar to the"abscopal effect"in radiotherapy,and the same results can be observed in some animal experiments.The results of abscopal effect in cryotherapy are still controversial,but some studies that failed to observe the abscopal effect also confirmed the effectiveness of cryotherapy in the treatment of malignant tumors.The application of cryotherapy in patients with malignant tumors has achieved good results.Combined therapy is also studied in animal experiments.Conclusions The mechanism of cryotherapy in the treatment of malignant tumors with abscopal effect still needs further study,and the combined application of cryotherapy and immunotherapy in clinical trials will promote the development of new modes of malignant tumor treatment.

关 键 词：冷冻治疗 恶性肿瘤 远隔效应 联合治疗 免疫功能 

分 类 号：R730.5[医药卫生—肿瘤]