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The need of radiotherapy optimization for glioblastomas considering immune responses

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Title: The need of radiotherapy optimization for glioblastomas considering immune responses
Authors: Nishioka, Kentaro Browse this author →KAKEN DB
Takahashi, Shuhei Browse this author
Mori, Takashi Browse this author
Uchinami, Yusuke Browse this author
Yamaguchi, Shigeru Browse this author
Kinoshita, Manabu Browse this author
Yamashina, Masaaki Browse this author
Higaki, Hajime Browse this author
Maebayashi, Katsuya Browse this author
Aoyama, Hidefumi Browse this author →KAKEN DB
Keywords: Glioblastoma
Target definitions
Issue Date: 1-Oct-2023
Publisher: Springer
Journal Title: Japanese Journal of Radiology
Volume: 41
Issue: 10
Start Page: 1062
End Page: 1071
Publisher DOI: 10.1007/s11604-023-01434-x
Abstract: Glioblastoma is the most common of malignant primary brain tumors and one of the tumors with the poorest prognosis for which the overall survival rate has not significantly improved despite recent advances in treatment techniques and therapeutic drugs. Since the emergence of immune checkpoint inhibitors, the immune response to tumors has attracted increasing attention. Treatments affecting the immune system have been attempted for various tumors, including glioblastomas, but little has been shown to be effective. It has been found that the reason for this is that glioblastomas have a high ability to evade attacks from the immune system, and that the lymphocyte depletion associated with treatment can reduce its immune function. Currently, research to elucidate the resistance of glioblastomas to the immune system and development of new immunotherapies are being vigorously carried out. Targeting of radiation therapy for glioblastomas varies among guidelines and clinical trials. Based on early reports, target definitions with wide margins are common, but there are also reports that narrowing the margins does not make a significant difference in treatment outcome. It has also been suggested that a large number of lymphocytes in the blood are irradiated by the irradiation treatment to a wide area in a large number of fractionations, which may reduce the immune function, and the blood is being recognized as an organ at risk. Recently, a randomized phase II trial comparing two types of target definition in radiotherapy for glioblastomas was conducted, and it was reported that the overall survival and progression-free survival were significantly better in a small irradiation field group. We review recent findings on the immune response and the immunotherapy to glioblastomas and the novel role of radiotherapy and propose the need to develop an optimal radiotherapy that takes radiation effects on the immune function into account.
Type: article
Appears in Collections:医学院・医学研究院 (Graduate School of Medicine / Faculty of Medicine) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

Submitter: 西岡 健太郎

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