实用肿瘤学杂志 ›› 2015, Vol. 29 ›› Issue (2): 162-166.doi: 10.11904/j.issn.1002-3070.2015.02.015

• 综述 • 上一篇    下一篇

胸部放疗联合EGFR-TKIs致肺纤维化的研究进展

张倩(综述),乔文波(审校)   

  1. 哈尔滨医科大学附属肿瘤医院放疗科(哈尔滨 150081)
  • 收稿日期:2014-09-04 出版日期:2015-04-28 发布日期:2015-05-05
  • 通讯作者: 乔文波,E-mail:wenboq@163.com E-mail:wenboq@163.com
  • 作者简介:张倩,女,(1988-),硕士研究生,从事放射性肺损伤的研究
  • 基金资助:
    黑龙江省教育厅科学基金项目(11531194)

Advances in pulmonary fibrosis caused by thoracic radiotherapy combined with EGFR-TKIs

ZHANG Qian,QIAO Wenbo   

  1. Department of Radiation Therapy,The Affiliated Tumor Hospital of Harbin Medical University,Harbin 150081,China
  • Received:2014-09-04 Online:2015-04-28 Published:2015-05-05

摘要: 胸部放射治疗是非小细胞肺癌(Non-small cell lung cancer,NSCLC)局部治疗的重要手段,而表皮生长因子受体酪氨酸激酶抑制剂(Epidermal growth factor receptor-tyrosine kinase inhibitor,EGFR-TKIs)具有全身治疗的作用,研究表明EGFR外显子19、21突变阳性的NSCLC患者放疗与EGFR-TKIs联合治疗时具有增效作用。放疗可激活EGFR信号通路,诱导细胞的增殖和DNA损伤修复,从而导致放射抵抗,因此EGFR-TKIs具有增加放疗敏感性的作用。两者联合治疗时最常见的副反应是肺损伤。研究提示放疗联合EGFR-TKIs在肺纤维化发展中具有矛盾作用,这些研究间差异的存在可能是因为实验系统的不同,纤维化模型的差异,以及不同物种和个体间的差异。因此需要对肺纤维化的病因有更完整的理解,以促进治疗进展。

Abstract: Thoracic radiotherapy is an important means of local treatment for non-small cell lung cancer(NSCLC).Epidermal growth factor receptor tyrosine kinase inhibitors(EGFR-TKIs)have the effect of systemic therapy.Studies have shown that NSCLC patients with EGFR exons 19,21 mutation have a synergistic effect in the combination therapy.Radiotherapy activates EGFR signaling pathway,inducing cell proliferation and DNA damage repair,leading to radiation resistance.Therefore,EGFR-TKIs have the effect in increasing radiosensitivity.Lung injury is one of the most common side effects when the two therapies combined.Studies suggest that radiotherapy combined with EGFR-TKIs may have conflicting functions in the development of pulmonary fibrosis,the discrepancy between these studies may depend on the differences in the experimental systems,the differences in pulmonary fibrosis models,as well as the differences between different species and individuals.Therefore,a more complete understanding of the etiology for pulmonary fibrosis is necessary to the development of improved treatments.

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