淋巴结预防性照射对机体免疫的影响

Research progress in the mechanism of elective nodal irradiation inhibiting anti-cancer immune response

免疫治疗时代,肿瘤患者的“阴性淋巴结”预防性照射的利弊需要重新评估。淋巴结属于免疫器官,是肿瘤患者的重要免疫屏障,也是放疗激活免疫的重要结构。诸多动物实验显示,正常区域淋巴结受到预防性照射或手术切除后,肿瘤单纯放疗后的肿瘤微环境内细胞毒性T细胞明显减少,放射抵抗增加,肿瘤退缩不明显。放疗联合免疫检查点抑制剂时,淋巴结预防性照射者的远隔效应也明显减弱。本文对相关的机制研究进行综述。

In the era of immunotherapy,the advantages and limitations brought from elective nodal irradiation(ENI)needs to be re-evaluated.As immune organs,lymph nodes play a crucial role as barriers against cancer,and are involved in the activation of anti-tumor responses during radiotherapy.Numerous animal experiments have demonstrated a significant depletion of cytotoxic T cells in the tumor microenvironment,along with an increase in radiation resistance after ENI or surgical resection,leading to limited tumor regression.Furthermore,the abscopal effect stimulated by radiotherapy is markedly attenuated when ENI is combined with immunotherapy.In this article,research progress in the underlying mechanisms was reviewed.