研究表明，慢性压力会影响放射治疗的效果

研究表明，慢性压力会影响放射治疗的效果

Radiation is one of the oldest and most common therapies for cancer, and typically is delivered locally, or to specific targeted sites in the body. While it has long been thought that locally-delivered radiation therapy typically does not help to shrink tumors outside the field of irradiation, new preclinical research from a team at Roswell Park Comprehensive Cancer Center suggests a strategy for significantly increasing both the local and distant, or "abscopal," effects of radiation. Results of the study, which was led by Elizabeth Repasky, PhD, have been newly published in Nature Communications.

放射疗法是最古老、最常见的癌症治疗方法之一，通常是局部地进行治疗，或者是对身体特定的靶点进行治疗。 尽管长期以来人们一直认为，局部放射治疗通常无助于缩小放射治疗领域之外的肿瘤，但罗斯韦尔帕克综合癌症中心(Roswell Park Comprehensive Cancer Center)的一个团队的新的临床前研究提出了一种策略，可以显著增加局部和远处的放射效应。 这项由Elizabeth Repasky博士领导的研究结果最近发表在《自然通讯》上。

"People often say, 'Stress is a part of life.' And while that's true, because there is frequently more stress that occurs in cancer patients because of their cancer diagnosis, we need to work to mitigate those enduring, longer-term stressors, because our work shows that it can inhibit the ongoing immune responses to cancer and an individual's response to therapy," adds Minhui Chen, PhD, a senior postdoctoral researcher in Dr. Repasky's lab, and first author on the study.

“人们常说，‘压力是生活的一部分。’ 尽管这是事实，因为癌症患者经常因为癌症诊断而承受更多的压力，我们需要努力减轻这些持久的、长期的压力，因为我们的工作表明，它可以抑制对癌症的持续免疫反应和个人对治疗的反应。” Repasky 博士实验室的高级博士后医学博士、该研究的第一作者 Minhui Chen 博士补充说。

The effects the team observed in their preclinical study hinge upon the body's "fight or flight" response to stresses through the network of nerves and organs known as the adrenergic nervous system.

研究小组在临床前研究中观察到，人体对压力的“战斗或逃跑”反应，通过神经和器官网络即肾上腺素能神经系统产生影响。

The team reports that when adrenergic stress was lessened, triggering lower levels of the neurotransmitters adrenaline and norepinephrine, tumor control in both irradiated and non-irradiated sites improved. This enhancement of the effects of radiation therapy also occurred when signaling through the β2-adrenergic receptor was reduced, suggesting that blockade of β2 adrenergic signaling could be a safe and feasible option for patients receiving radiation. Based on earlier preclinical research, Dr. Repasky and colleagues are investigating in clinical studies whether the efficacy of chemotherapy and immunotherapy can be improved by giving patients beta blockers, such propranolol -; a common blood pressure medication.

研究小组报告说，当肾上腺素能应激减轻，引发较低水平的神经递质肾上腺素和去甲肾上腺素时，辐射和非辐射部位的肿瘤控制都得到改善。 当通过2肾上腺素能受体发出的信号减少时，放射治疗效果也增强了，这表明阻断2肾上腺素能信号对于接受放射治疗的患者来说是一个安全可行的选择。 基于早期的临床前研究，Repasky 博士和他的同事们正在进行临床研究，探讨是否可以通过给患者服用 β 受体阻滞剂，如普萘洛尔，来提高化疗和免疫疗法的疗效。

"Researchers have suspected a relationship between stress and cancer treatment outcomes for some time, but many questions remain," notes co-author Anurag Singh, MD, Director of Radiation Research and Professor of Oncology in the Department of Radiation Medicine at Roswell Park. "This research has uncovered a major molecular and immunological pathway that appears to underlie the association between how much stress an individual is experiencing and how they respond to cancer therapy. Our results suggest that by blocking the β2 adrenergic receptor, you may not only make radiation and chemotherapy work better, you give a boost to the immune system -; and may even be able to reduce metastasis, or spread of a tumor to a different part of the body."

“一段时间以来，研究人员一直怀疑压力和癌症治疗结果之间的关系，但许多问题仍然存在，”Roswell Park 放射医学部放射研究主任和肿瘤学教授、该研究合著者 Anurag Singh 表示， “这项研究揭示了一个主要的分子和免疫途径，它似乎是个体所经历的压力程度和他们对癌症治疗的反应之间关系的基础。 我们的研究结果表明，通过阻断肾上腺素能受体，你不仅可以使放疗和化疗更好地发挥作用，还可以增强免疫系统，甚至可以减少肿瘤的转移或扩散到身体的其他部位。”

New clinical trials are underway or in development at Roswell Park to confirm and expand on these findings in patients and investigate which interventions are most effective at mitigating the effects of stress.

Roswell Park 正在进行或开展新的临床试验，以确认和扩展这些在患者身上的发现，并调查哪些干预措施最有效地减轻压力的影响。