放疗和免疫治疗在远隔效应中的角色及临床争议  

The roles and clinical controversies of radiotherapy and immunotherapy in abscopal effect

作　　者：张璐[1] 刘宏博 丁晓[2] 陆海军[2] Zhang Lu;Liu Hongbo;Ding Xiao;Lu Haijun(Qingdao University,Qingdao 266071,China;Department of Radiotherapy,the Affiliated Hospital of Qingdao University,Qingdao 266003,China)

机构地区：[1]青岛大学,青岛266071 [2]青岛大学附属医院肿瘤放疗科,青岛266003

出　　处：《中华放射肿瘤学杂志》2023年第5期470-475,共6页Chinese Journal of Radiation Oncology

基　　金：北京白求恩公益基金会项目(BQE-TY-SSPCCD-N-03)。

摘　　要：早在20世纪初,就有人观察到放射治疗作为一种局部治疗手段,可以启动适应性免疫系统,导致放射野外肿瘤的自发消退,该现象称为远隔效应。尽管远隔效应的发生仍较罕见,但随着免疫疗法应用的增多,越来越多出现远隔效应的临床病例被报道,人们愈发关注放疗引起全身抗肿瘤反应的治疗潜力,尤其是放疗与免疫疗法的联合,让远隔效应更具研究价值。但其机制仍未完全阐明,放疗最佳的时机、剂量与分割也处于探索过程中,如何对患者进行受益群体分类,也是需要重点关注的问题。本文简要介绍了远隔效应的历史、放疗与免疫治疗在远隔效应中的角色,并关注临床应用角度仍存在的争议,以期明确目前研究发展的方向,早日翻开肿瘤治疗的新篇章。As early as the 20th century,it has been observed that radiotherapy(RT),as a local therapy,can activate the adaptive immune system,resulting in spontaneous regression of tumors out of the radiation field,which is known as"abscopal effect".Although the occurrence of abscopal effect is still rare,with the gradual increase in the application of immunotherapy,more and more clinical cases of abscopal effect have been reported.Increasing attention has been paid to the therapeutic potential of RT in inducing systemic anti-tumor response.Especially,the combination of RT and immunotherapy enhances the research value of abscopal effect.However,its mechanism has not been fully elucidated,and the optimal timing,dose and fractionation of RT are also under study.How to classify the beneficiary groups is also a key issue.In this article,the history of abscopal effect,and the role of RT and immunotherapy in this phenomenon were briefly introduced,and the existing controversies in clinical application were illustrated,aiming to clarify the direction of current research and development and open a new chapter for tumor treatment in a short period of time.

关 键 词：放射疗法 远隔效应 免疫疗法 免疫抑制微环境 

分 类 号：R730.5[医药卫生—肿瘤]