放射性颞叶损伤破坏神经-免疫交互：局部晚期鼻咽癌免疫功能障碍的关键驱动因素。
Radiation-induced temporal lobe injury disrupts neuro-immune crosstalk: A key driver of immune dysfunction in locally advanced nasopharyngeal carcinoma.
文献信息
| PMID | 42754404 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Juan Gao |
| 作者单位 | Department of Radiation Oncology, Hubei Cancer Hospital, TongJi Medical College, Huazhong University of Science and Technology, China. |
| 期刊 | The Journal of international medical research |
| SCI 分区 | Q3 |
| IF | 1.8 |
| 研究类型 | 综述 Meta · 临床 |
| 所属专科 | 鼻咽癌 |
中文摘要
鼻咽癌在中国高度流行。以放疗为中心的联合治疗显著提高了局部晚期鼻咽癌患者的5年总生存率，超过80%。然而，放射性颞叶损伤仍是一种严重的晚期并发症。尽管精准放疗取得了进展，其发生率仍为5%-15%，显著影响患者的预后和生活质量。放射性颞叶损伤由多种机制触发，包括辐射直接诱导的神经元和胶质细胞损伤、内皮损伤导致的缺血缺氧，以及以M1小胶质细胞为主的免疫炎症反应失衡。重要的是，放射性颞叶损伤破坏神经-免疫交互，导致外周淋巴细胞和自然杀伤细胞减少、促炎细胞因子增加以及全身免疫抑制，从而进一步增加感染和肿瘤复发风险。本叙述性综述遵循叙述性综述文章评估量表。我们系统检索并整理了已发表的关于放射性颞叶损伤的临床和临床前研究，并全面总结了放射性颞叶损伤的发病机制；其对免疫功能的调节作用；以及当前的预防和治疗策略，包括精准放疗优化和药物干预。本综述旨在为理解放射性颞叶损伤的机制以及鼻咽癌根治性放疗后的预防和治疗策略提供理论基础，最终改善鼻咽癌根治性放疗后幸存者的长期生活质量。
英文摘要
Nasopharyngeal carcinoma is highly prevalent in China. Combined therapy centered on radiotherapy has significantly improved the 5-year overall survival rate of patients with locally advanced nasopharyngeal carcinoma, exceeding 80%. However, radiation temporal lobe injury remains a serious late complication. Despite advances in precision radiotherapy, its incidence is 5%-15%, considerably affecting the prognosis and quality of life of patients. Radiation temporal lobe injury is triggered by multiple mechanisms, including direct radiation-induced damage to neurons and glial cells, ischemia and hypoxia resulting from endothelial injury, and imbalanced immunoinflammatory responses dominated by M1 microglia. Importantly, radiation temporal lobe injury disrupts neuro-immune crosstalk, leading to a decrease in peripheral lymphocytes and natural killer cells, an increase in pro-inflammatory cytokines, and systemic immune suppression, thereby further increasing the risk of infection and tumor recurrence. This narrative review complies with the Scale for the Assessment of Narrative Review Articles. We systematically retrieved and organized published clinical and preclinical studies on radiation temporal lobe injury and comprehensively summarized the pathogenesis of radiation temporal lobe injury; its regulatory effects on immune function; and current prevention and treatment strategies, including precision radiotherapy optimization and drug intervention. This review aims to provide a theoretical basis for understanding the mechanisms underlying the radiation temporal lobe injury as well as prevention and treatment strategies after radical radiotherapy for nasopharyngeal carcinoma, ultimately improving the long-term quality of life of survivors of nasopharyngeal carcinoma following radical radiotherapy.