Radiotherapy may induce off-target antitumor “abscopal” immunostimulatory but also immunosuppressive effects. Several preclinical and early clinical studies revealed promising results when combining radiation therapy with immunostimulatory agents. However, most immunoradiotherapy randomized trials showed disappointing results in patients with advanced tumors. On the contrary, encouraging outcomes were suggested when immunotherapy was delivered on top of gross disease elimination with curative-intent radiotherapy. In this review, we highlight available results from randomized trials and discuss the potential impact of overall tumor burden on the observed efficacy of radioimmunotherapy.

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根除大体肿瘤疾病：有效放射免疫治疗的先决条件？

放射治疗可能会引起脱靶抗肿瘤“远隔”免疫刺激作用，但也可能产生免疫抑制作用。几项临床前和早期临床研究显示，放射治疗与免疫刺激剂相结合时取得了有希望的结果。然而，大多数免疫放射治疗随机试验在晚期肿瘤患者中显示出令人失望的结果。相反，当在根治性放疗消除总体疾病的基础上进行免疫治疗时，结果令人鼓舞。在这篇综述中，我们重点介绍了随机试验的现有结果，并讨论了总体肿瘤负荷对放射免疫治疗观察到的疗效的潜在影响。