放疗联合免疫治疗癌症的研究进展

摘要

Radiotherapy not only acts as an important local treatment of cancer, but also plays a key role in regulation of immune function. Radiotherapy regulates anti⁃tumor immune responses by promoting the generation of neoantigens, regulating the release of cytokine, and enhancing the sensitivity of tumor to cell⁃mediated immunity. Recently, several studies and clinical practice reported the abscopal effect in some patients undergoing radiotherapy combined with immunotherapy, which showed partial or complete response of metastases outside the irradiation field, suggesting the combination therapy as a promising strategy. However, further studies are needed for the understanding of the mechanism and influencing factors for immunity such as radiation dose and fractionation scheme. This paper reviews the research advances in the mechanism of radiotherapy⁃immunotherapy interaction and the combination therapy for cancer.%放疗不仅是肿瘤局部治疗的重要手段，同时也对免疫功能有重要的调节作用。放疗可通过产生新抗原、调节细胞因子释放、提高肿瘤对免疫细胞杀伤作用敏感性等方式调节机体抗肿瘤免疫应答。近年来部分研究和临床实践发现，放疗联合免疫治疗在部分病例中出现“远位效应”，照射野范围外的转移性病灶有部分或完全缓解，显示放疗联合免疫治疗的良好前景；但相关机制以及放疗剂量、分割方式等因素对免疫的影响仍有待进一步研究。本文综述了放疗影响免疫的机制以及放疗联合免疫治疗的研究进展。