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Changes in peripheral immune cells after intraoperative radiation therapy in low-risk breast cancer
Authors:Isabel Linares-Galiana  Miguel Angel Berenguer-Frances  Rut Caas-Corts  Monica Pujol-Canadell  Silvia Comas-Antn  Evelyn Martínez  Maria Laplana  Hctor Prez-Montero  María Jesús Pla-Farns  Arturo Navarro-Martin  Miriam Nuez  Brigitte Both  Ferran Guedea
Abstract:A detailed understanding of the interactions and the best dose-fractionation scheme of radiation to maximize antitumor immunity have not been fully established. In this study, the effect on the host immune system of a single dose of 20 Gy through intraoperative radiation therapy (IORT) on the surgical bed in low-risk breast cancer patients undergoing conserving breast cancer has been assessed. Peripheral blood samples from 13 patients were collected preoperatively and at 48 h and 3 and 10 weeks after the administration of radiation. We performed a flow cytometry analysis for lymphocyte subpopulations, natural killer cells (NK), regulatory T cells (Treg) and myeloid-derived suppressor cells (MDSCs). We observed that the subpopulation of NK CD56+high CD16+ increased significantly at 3 weeks after IORT (0.30–0.42%, P < 0.001), while no changes were found in immunosuppressive profile, CD4+CD25+Foxp3+Helios+ Treg cells, granulocytic MDSCs (G-MDSCs) and monocytic MDSCs (Mo-MDSCs). A single dose of IORT may be an effective approach to improve antitumor immunity based on the increase in NK cells and the non-stimulation of immunosuppressive cells involved in immune escape. These findings support future combinations of IORT with immunotherapy, if they are confirmed in a large cohort of breast cancer patients.
Keywords:immune system  immunomodulation  flow cytometry  immunophenotyping  breast cancer  intraoperative radiation therapy
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