恶性肿瘤立体定向放疗联合免疫治疗研究进展

手术、放疗及化疗是恶性肿瘤的三种传统治疗方式。随着医学的发展,免疫治疗逐渐走进人们的视野,并成为恶性肿瘤治疗的一支新兴力量。近年来的一些临床研究表明放疗联合免疫治疗可以增强机体抗肿瘤免疫,改善患者预后。立体定向放疗单次剂量大,精度高,相比常规放疗更能诱发远隔效应及机体抗肿瘤应答,与免疫治疗联合应用更具前景,这在一些临床研究中已经初步显现。然而,在实际临床应用中,并非所有类型的肿瘤都能在联合治疗时获益,有关联合治疗时的最佳放疗剂量与分割方式、放疗靶病灶的选择、免疫调节剂、安全性等问题尚不明确。本文旨在就恶性肿瘤立体定向放疗联合免疫治疗的进展、相关争议及未来研究方向进行综述。

Research progress on stereotactic radiotherapy combined with immunotherapy for malignancies

Surgery, radiotherapy and chemotherapy are three traditional treatments for malignant tumors. With the development of medicine, immunotherapy has been gradually adopted as an emerging therapy of malignancies. Recent clinical studies have demonstrated that the combination of radiotherapy and immunotherapy can induce the abscopal effect and improve the prognosis of patients. Compared with the conventional radiotherapy, stereotactic radiotherapy has a larger single dose and higher accuracy, which is more likely to induce the bystander effect and anti-tumor response. The combination of stereotactic radiotherapy and immunotherapy has been proven to be a more promising therapy in certain clinical trials. However, not all types of tumors can benefit from such combined therapy in clinical practice. The optimal dose, fraction pattern and lesion of radiotherapy, immune enhancement and safety remain to be further clarified. In this article, the research progress, related controversies and future research direction of stereotactic radiotherapy combined with immunotherapy for malignancies were reviewed.