大分割放疗联合免疫检查点抑制剂在头颈部肿瘤中的研究进展

Advances in Hypofractionated Radiotherapy Combined with Immune Checkpoint Inhibitors for Head and Neck Cancer

摘要: 头颈癌是全球第六大常见的肿瘤，早期患者以单一的手术或者放疗为主要治疗方式，但面对晚期或者复发的头颈部肿瘤患者，需要多模式的治疗方法。近年来，以免疫检查点抑制剂为代表的免疫疗法改变了肿瘤治疗，为患者提供了新的治疗选择。放疗作为头颈部肿瘤的重要治疗方式，具有免疫调节和免疫刺激的作用，即远隔效应，这一现象报道并不多且主要在相对高剂量的放疗中观察到但仍备受人们关注，因此研究者们对放疗和免疫治疗之间的协同作用产生了兴趣。本综述分别介绍了大分割放疗和免疫检查点抑制剂的作用机制，并阐述了两者联合在头颈部肿瘤的治疗中应用的理论依据，并总结了当前的一些临床前和临床证据，以及这种联合治疗存在的挑战和问题。

Abstract: Head and neck cancer ranks as the sixth most common malignancy globally. Early-stage patients receive surgery or radiotherapy alone as primary treatment, while multimodal therapy is indicated for advanced or recurrent cases. Immune checkpoint inhibitor-based immunotherapy has revolutionized cancer management and offered new therapeutic alternatives. Radiotherapy, a core modality for head and neck malignancies, induces immunomodulatory and immunostimulatory effects known as the abscopal effect. Though rarely reported and mostly observed at relatively high radiation doses, this phenomenon has sparked research interest in radiotherapy‑immunotherapy synergy. This review describes the mechanisms of hypofractionated radiotherapy and immune checkpoint inhibitors, explains the theoretical basis for their combined use in head and neck cancer, and summarizes existing preclinical and clinical evidence, along with challenges of this combinatorial strategy.