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恶性肿瘤是严重危害人类健康的疾病之一,尽管有手术、放疗及化疗等多种传统方法及免疫治疗等多种新方法与新策略的应用,但美国国立卫生院(National institute of health NIH)统计显示,目前恶性肿瘤的5年生存率与20世纪60年代相比未见明显改善。导致恶性肿瘤治疗效果不佳的原因较多,如多种分子变异及分子间网络化交互作用的调控机制增加了肿瘤发生的复杂性;肿瘤发生过程存在肿瘤新生血管、细胞增殖、肿瘤侵袭、转移等多种病理过程,呈现复杂的异质性;同时肿瘤组织中除肿瘤细胞外,还有肿瘤干细胞及耐药细胞等。这些因素的共同作用导致了目前的治疗方法难以有效抑制肿瘤的生长。
放射性核素衰变过程产生的射线可通过电离辐射生物效应导致细胞DNA及其他功能性大分子的损伤,从而导致细胞凋亡,因此,利用射线进行肿瘤治疗成为重要方法。当放射性核素进入肿瘤细胞后,其产生的射线除可作用于核素所在肿瘤细胞外,由于其穿透力较强,还可通过“旁效应”作用于周围无核素摄取的肿瘤细胞,同时肿瘤细胞间也可通过“交叉火力”(crossfire)进一步增强对肿瘤细胞的杀伤力,提升肿瘤治疗效果。肿瘤核素治疗的关键在于将放射性核素定向导入肿瘤组织,提高肿瘤治疗的靶向性[1]。利用抗原与抗体、配体与受体特异性结合的特点,分别形成了以放射性核素标记抗体进行治疗的放射免疫治疗(radioimmunotherapy,RIT)及以核素标记配体进行的放射受体治疗。这些方法已显示出对肿瘤治疗的可喜效果,部分已经进入临床应用。
肿瘤核素靶向治疗新进展
Advance progress of radionuclide target tumor therapy
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摘要: 利用靶向分子将放射性核素定向导入肿瘤组织实现核素靶向治疗是肿瘤治疗的重要方法。利用单克隆抗体或小分子肽携带治疗性放射性核素,分别与肿瘤细胞表面表达丰富的抗原或受体特异性结合而开展放射免疫治疗或受体介导的核素治疗是靶向治疗的主要策略。近年来,这两种靶向治疗取得较大进展,部分已进入临床应用。随着靶向分子的不断出现、分子靶向技术的不断完善,肿瘤核素靶向治疗终将成为肿瘤治疗的重要方法。Abstract: Radionuclide internal therapy is an important method for tumor treatment. Radioimmunotherapy(RIT)and peptide receptor radionuclide therapy(PPRT)are two major strategies for tumor therapy by targeting antigen or receptor over-expressed in tumor cells with radionuclide labeled monoclonal antibody or peptide separately. RIT and PPRT have been dramatically developed with several agents have been used in clinic and more are underwent clinic or pre-clinic trial. The radionuclide therapy will play more important role in tumor therapy with the more specific target been selected and improvement of the methods.
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Key words:
- Tumor /
- Antibodies, monoclonal /
- Radionuclidetherapy /
- Radioimmunotherapy
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