oncotomskСибирский онкологический журналSiberian journal of oncology1814-48612312-3168Tomsk National Research Medical Сепtеr of the Russian Academy of Sciences10.21294/1814-4861-2020-19-5-108-113oncotomsk-1585Research ArticleОБЗОРЫREVIEWSИММУНОЛОГИЧЕСКИЕ ЭФФЕКТЫ СТЕРЕОТАКСИЧЕСКОЙ ЛУЧЕВОЙ ТЕРАПИИ ПРИ ЗЛОКАЧЕСТВЕННЫХ НОВООБРАЗОВАНИЯХ РАЗЛИЧНЫХ ЛОКАЛИЗАЦИЙ: ОБЗОР ЛИТЕРАТУРЫIMMUNE EFFECTS OF STEREOTACTIC ABLATIVE RADIATION THERAPY IN PATIENTS WITH MALIGNANT TUMORS: LITERATURE REVIEWhttps://orcid.org/0000-0003-0635-6967ЗозуляА. Ю.ZozulyaA. Yu.

аспирант, младший научный сотрудник отдела онкоиммунологии,

197758, г. Санкт-Петербург, ул. Ленинградская, 68

MD, Postgraduate, Medical Oncologist, Junior Researcher of the Department of Oncoimmunology, 

68, Leningradskaya Street, 197758-St. Petersburg

antonzozulya@yandex.ruhttps://orcid.org/0000-0002-7472-4613БалдуеваИ. А.BalduevaI. A.

доктор медицинских наук, заведующая отделением онкоиммунологии,

197758, г. Санкт-Петербург, ул. Ленинградская, 68

MD, DSc, Associate Professor, Head of the Department of Oncoimmunology,

68, Leningradskaya Street, 197758-St. Petersburg

https://orcid.org/0000-0002-7185-1967НовиковС. Н.NovikovS. N.

доктор медицинских наук, заведующий отделением радиотерапии,

197758, г. Санкт-Петербург, ул. Ленинградская, 68

MD, DSc, Head of the Department of Radiotherapy,

68, Leningradskaya Street, 197758-St. Petersburg

ФГБУ «НМИЦ онкологии им. Н.Н. Петрова» Минздрава РоссииРоссияN.N. Petrov National Medical Research Center of Oncology, Ministry of Health of the Russian FederationRussian Federation202029102020195108113Copyright © Зозуля А.Ю., Балдуева И.А., Новиков С.Н., 20202020Зозуля А.Ю., Балдуева И.А., Новиков С.Н.Zozulya A.Y., Baldueva I.A., Novikov S.N.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.siboncoj.ru/jour/article/view/1585

Цель исследования – провести систематический анализ данных, имеющихся в современной литературе, о системных (абскопальных) эффектах лучевой терапии, которые опосредованы иммунологическими феноменами.

Материал и методы

Материал и методы. Произведен структурированный поиск рецензируемых статей в системе MEDLINE за период с января 2000 г. по февраль 2019 г. В обзор включены данные зарегистрированных клинических испытаний на Clinicaltrials.gov, представляющие итоги совместного применения иммунотерапии и лучевой терапии.

Результаты

Результаты. На данный момент, согласно литературным данным, существует мнение, что системное действие радиотерапии опосредовано иммунологическими феноменами. В связи с последними успехами иммунотерапии растет интерес к ее совместному применению с лучевой терапией с целью увеличения частоты системных эффектов. Однако частота возникновения абскопальных эффектов после применения стандартного лучевого лечения остается невысокой. В этой связи стереотаксическая лучевая терапия, учитывая ее выраженные иммуногенные свойства, возможность обеспечения высокого уровня локального контроля опухоли в полях облучения, низкий уровень токсичности и короткие сроки лечения, вероятно, является идеальным партнером для иммунотерапии у пациентов с метастатическим опухолевым процессом. Анализ данных показал, что сочетание стереотаксической лучевой терапии и иммунотерапии видится одним из наиболее прогрессивных подходов в лечении онкологических пациентов с точки зрения достижения абскопального эффекта и иммунологического контроля над метастатическим опухолевым процессом.

Заключение

Заключение. Учитывая вышесказанное и многогранность иммунологических эффектов радиотерапии, необходимы дальнейшие исследования влияния лучевой терапии на иммунную систему онкологических больных, продолжение совместного применения различных комбинаций иммунотерапии и лучевой терапии. Всё это в конечном итоге будет способствовать улучшению показателей выживаемости онкологических пациентов.

The purpose of the study was to conduct a systematic analysis of the data available in the modern literature on the systemic (abscopal) effects in radiation therapy, which are mediated by immunological phenomena.

Material and Methods

Material and Methods.A structured search for articles published in peer-reviewed journals between January 2000 and February 2019 was conducted using MEDLINE database. The review included data from registered clinical trials at Clinicaltrials.gov, showing the results of the combined use of immunotherapy and radiation therapy.

Results

Results. There is an opinion that the systemic effect of radiotherapy is mediated by immunological phenomena. In connection with the recent data, there is a growing interest in the combined use of immunotherapy with radiation therapy in order to increase the efficacy of systemic therapy. However, the incidence of abscopal effects after standard radiation treatment is very low. In this regard, stereotactic ablative radiotherapy, due to its high immunogenic potential, low toxicity and short duration of the treatment, is apparently an attractive partner for immunotherapy in patients with metastatic disease.

Conclusion

Conclusion. In view of the variety of the immunological effects of radiotherapy, further studies of the effect of radiation therapy on the immune system of cancer patients are needed, and the use of various combinations of immunotherapy and radiation therapy should be continued. All this, ultimately, will help improve the survival rates of cancer patients. 

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The authors declare that there are no conflicts of interest present.