SBRT立体放疗和白介素的协同作用

下面有几个参考资料。看到国外有几个病人在讨论，就贴过来了。
http://stm.sciencemag.org/content/4/137/137ra74.abstract

http://www.translational-medicin ... 479-5876-10-104.pdf

http://oregon.providence.org/pat ... guns+to+kill+cancer

第一个链接是个临床试验。12个黑色素和肾癌的人入组。白介素后用SBRT，8个人产生反应，1个CR和7个PR。6个ct显示PR的病人pet显示是CR。
看病人讨论说可能那些放疗死的细胞会被当做免疫反应的抗原，更容易激起免疫反应blabla的。。
坛子里对白介素似乎没啥兴趣，所以放在这供有兴趣的人参考吧，而且看来放疗也不是完全没用，看到国外有些人也会选择用射波刀做掉大的病灶。。我总是想有机会还是想让爸爸去试试免疫疗法，毕竟这么年轻，如果能有治愈的机会比一辈子吃药强。。

Preclinical models suggest that focal high-dose radiation can make tumors more immunogenic. We performed a pilot study of stereotactic body radiation therapy (SBRT) followed by high-dose interleukin-2 (IL-2) to assess safety and tumor response rate and perform exploratory immune monitoring studies. Patients with metastatic melanoma or renal cell carcinoma (RCC) who had received no previous medical therapy for metastatic disease were eligible. Patients received one, two, or three doses of SBRT (20 Gy per fraction) with the last dose administered 3 days before starting IL-2. IL-2 (600,000 IU per kilogram by means of intravenous bolus infusion) was given every 8 hours for a maximum of 14 doses with a second cycle after a 2-week rest. Patients with regressing disease received up to six IL-2 cycles. Twelve patients were included in the intent-to-treat analysis, and 11 completed treatment per the study design. Response Evaluation Criteria in Solid Tumors criteria were used to assess overall response in nonirradiated target lesions. Eight of 12 patients (66.6%) achieved a complete (CR) or partial response (PR) (1 CR and 7 PR). Six of the patients with PR on computed tomography had a CR by positron emission tomography imaging. Five of seven (71.4%) patients with melanoma had a PR or CR, and three of five (60%) with RCC had a PR. Immune monitoring showed a statistically significantly greater frequency of proliferating CD4+ T cells with an early activated effector memory phenotype (CD3+CD4+Ki67+CD25+FoxP3−CCR7−CD45RA−CD27+CD28+/−) in the peripheral blood of responding patients. SBRT and IL-2 can be administered safely. Because the response rate in patients with melanoma was significantly higher than expected on the basis of historical data, we believe that the combination and investigation of CD4+ effector memory T cells as a predictor of response warrant further study.

另一个 http://meetinglibrary.asco.org/content/107097-134

entinostat+高剂量白介素

8个病人，四个产生反应。

做凡人 发表于 2013-8-31 10:28

                               
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另一个 http://meetinglibrary.asco.org/content/107097-134

entinostat+高剂量白介素

一个人写的各种治疗的估测反应率，先放在这

IL-2 + HCQ or entinostat trial (perhaps 12-15% chance of CR)
IL-2 (6% chance of CR)
PD-1+CTLA combo trial (early days - maybe 18% CR when they get it right)
PD-1 monotherapy (around 5-8% CR but about 40% chance of sustained stability)
Anti angiogenesis meds (1% chance of CR - 40% chance of significant PR and sustained PFS)
IL-15 - only about 6 RCC patient have received it - some temporary partial responses but 0% reported CR

做了伽马刀也可以白介素吗？要多高的剂量？

jove9999 发表于 2013-10-15 16:28

                               
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做了伽马刀也可以白介素吗？要多高的剂量？

这个不到万不得已暂时不要自己试，如果有条件的话还是去开展的医院，不过国内貌似没啥人在做。。或许坛子上有人有条件可以出去治，也或许有天医院会开展，我就放上来了。。
国外先高剂量白介素是主流，不知道为啥我们这就没有。。
我个人觉得什么刀不是最主要的，看大家讨论似乎是还没代谢的癌细胞尸体因为没法藏匿，身体在白介素的激发下会更容易起免疫反应。。

还有一种低剂量的白介素加上干扰素，楼主有这方面的数据吗