Читать книгу Advances in Radiation Therapy - Группа авторов - Страница 27

There are intense discussions about the dose and fractionation of radiotherapy combined with immunotherapy. Clinically, multiple radiation schedules are tested for different cancer entities [93]. For the combination with immune checkpoint inhibition, preclinical data suggest an advantage of hypofractionated over single dose regimens [69]. The activation of dendritic cells has been shown for hypofractionated and normofractionated radiation regimes [94]. However, the ideal dose and fractionation has not yet been determined [51, 95]. Preclinical data and available case reports also suggest a superiority of simultaneous regimens or irradiation after the start of immune checkpoint inhibition over a schedule starting with irradiation [63, 69, 96]. The data on the introduction of immunotherapy into normofractionated regimens encompassing adjuvant lymphatic regions applied in neoadjuvant or adjuvant settings and for primary radio(-chemo) therapy is scarce. In addition, the optimal radiation dose, fractionation, and scheduling might differ depending on the immunotherapeutic strategy investigated.