放疗联合PD-1/PD-L1抑制剂治疗的协同机制及临床研究进展
Mechanisms and Clinical Research Advances in Radiotherapy Combined with PD-1/PD-L1 Inhibitor Therapy
DOI: 10.12677/acm.2025.1541327, PDF,   
作者: 王蒙佳, 孙晓南：浙江大学医学院附属邵逸夫医院放疗科，浙江 杭州
关键词: 放疗；免疫治疗；免疫检查点抑制剂；PD-1/PD-L1抑制剂；Radiotherapy； Immunotherapy； Immune Checkpoint Inhibitors； PD-1/PD-L1 Inhibitiors
摘要: 放疗与以免疫检查点抑制剂(如PD-1/PD-L1抑制剂)为主的免疫治疗，是实体瘤治疗的关键手段。本文聚焦放疗的免疫调节效应与二者联合应用，阐述放疗对正向免疫调节的作用机制、放疗与PD-1/PD-L1抑制剂联合时对肿瘤免疫微环境影响，远隔效应的发生等。相关临床试验显示，该联合治疗在非小细胞肺癌、肝细胞癌等多种实体瘤中展现出良好效果，但不同癌种获益有别。目前，联合治疗的最佳剂量、分割方案及时间安排策略尚存争议，需依据肿瘤类型和治疗目标进行个体化调整。本文系统梳理现有研究，为放疗与PD-1/PD-L1抑制剂联合治疗的临床实践提供全面科学依据与实用参考。
Abstract: Radiotherapy and immunotherapy mainly based on immune checkpoint inhibitors (such as PD-1/PD-L1 inhibitors) are key approaches for the treatment of solid tumors. This article focuses on the immunomodulatory effects of radiotherapy and their combined application. It elaborates on the mechanisms of radiotherapy’s positive immunomodulation, the impact of the combination of radiotherapy and PD-1/PD-L1 inhibitors on the tumor immune microenvironment, and the occurrence of the abscopal effect. Relevant clinical trials have demonstrated that this combined treatment has shown good efficacy in various solid tumors such as non-small cell lung cancer and hepatocellular carcinoma, yet the benefits vary among different cancer types. Currently, there are still controversies regarding the optimal dose, fractionation scheme, and timing strategy of the combined treatment, which need to be adjusted individually according to the tumor type and treatment goals. This article systematically reviews the existing research, providing a comprehensive scientific basis and practical reference for the clinical practice of the combined treatment of radiotherapy and PD-1/PD-L1 inhibitors.
文章引用：王蒙佳, 孙晓南. 放疗联合PD-1/PD-L1抑制剂治疗的协同机制及临床研究进展[J]. 临床医学进展, 2025, 15(4): 3538-3547. https://doi.org/10.12677/acm.2025.1541327

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