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据世界卫生组织统计,2018年,全世界共报道了1810万例癌症病例,因癌症而病死的人数多达960万[1]。目前,临床上治疗恶性肿瘤的主要方法包括手术切除、放疗和化疗等,其中放疗是最常见且最有效的治疗手段之一。据报道,超过50%的癌症患者曾使用放疗控制病情[2]。放疗主要通过电离辐射直接破坏DNA分子或者间接裂解水分子,形成活性氧自由基(reactive oxygen species,ROS)作用于DNA,杀伤肿瘤细胞[3],其可以通过外部的射线直接对肿瘤组织进行外照射或是利用体内引入的放射性核素衰变发射出射线进行内照射。但是,肿瘤内乏氧微环境导致的辐射抵抗现象和射线对正常组织的损伤作用,严重限制了放疗的效果及其长期应用[4]。新型放疗增敏剂的开发成为近年来的研究热点。一方面,放疗增敏剂可以增强肿瘤细胞对放疗的敏感性,提高射线对肿瘤细胞的杀伤效率,并降低对正常组织的辐射损伤。另一方面,放化疗联合策略可在减轻对正常组织不良作用的同时增强对肿瘤的治疗效果。随着纳米科学技术的快速发展,越来越多的高分子纳米材料凭借其独特的物理化学和生物学性质(如高效负载药物能力、优异的生物相容性和生理稳定性等),在肿瘤放疗领域显示出了良好的潜力[5-6]。笔者就高分子纳米材料用于肿瘤放疗增敏的研究进展进行综述。
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