肝细胞癌放射治疗抵抗的机制及应对策略

王钦波; 李术华; 孙航; 吴传新

doi:10.12449/JCH251029

肝细胞癌放射治疗抵抗的机制及应对策略

DOI: 10.12449/JCH251029

王钦波¹,
李术华²,
孙航²,
吴传新^1, , ,

1.
重庆医科大学附属第二医院，肝胆外科，重庆 400010
2.
重庆医科大学附属第二医院，感染与肝病研究院，重庆 400010

基金项目:

重庆市自然科学基金杰出青年项目 (CSTB2022NSCQ-JQX0032);

重庆医科大学未来医学青年创新团队支持计划 (W0156)

利益冲突声明：本文不存在任何利益冲突。

作者贡献声明：王钦波、李术华负责查阅论文资料，设计论文框架，撰写论文；吴传新、孙航指导撰写文章并最后定稿。

详细信息

通信作者:
吴传新， 300395@cqmu.edu.cn （ORCID： 0000-0002-1481-2582）

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- 被引次数: 0
出版历程
- 收稿日期: 2025-03-01
- 录用日期: 2025-05-06
- 出版日期: 2025-10-25

Mechanism of radiotherapy resistance in hepatocellular carcinoma and related coping strategies

1.
Department of Hepatobiliary Surgery, The Second Affiliated Hospital of Chongqing Medical University，Chongqing 400010，China
2.
Institute of Infection and Hepatology, The Second Affiliated Hospital of Chongqing Medical University，Chongqing 400010，China

Research funding:

Chongqing Science Fund for Distinguished Young Scholars (CSTB2022NSCQ-JQX0032);

Program for Youth Innovation in Future Medicine of Chongqing Medical University (W0156)

More Information

Corresponding author: WU Chuanxin， 300395@cqmu.edu.cn （ORCID： 0000-0002-1481-2582）

摘要

摘要: 原发性肝癌是一种在全球范围内发病率和死亡率持续上升的恶性肿瘤，给患者和社会带来了沉重的负担，其中肝细胞癌是原发性肝癌中的常见类型。放射治疗作为肝细胞癌的重要治疗手段之一，能够有效控制肿瘤的局部生长并缓解患者症状。然而，放疗抵抗问题严重影响了治疗效果，成为临床治疗中的一大挑战。当前研究表明，肝细胞癌放疗抵抗的机制较为复杂，涉及细胞内信号通路异常激活、肿瘤微环境变化以及基因表达调控等多种因素。因此，临床上提出一系列针对放疗抵抗的应对策略，包括调控细胞信号通路、改善肿瘤微环境、联合治疗等，这些策略展现出良好的应用前景。本文旨在综述放疗抵抗的相关机制及应对策略的研究进展，以期为肝细胞癌放疗研究提供新的视角。
- 癌，肝细胞 /
- 放疗抵抗 /
- 治疗学
Abstract: Primary liver cancer is a malignant tumor with continuously rising incidence and mortality rates worldwide， imposing a heavy burden on patients and society， and hepatocellular carcinoma （HCC） is a common type of primary liver cancer. As one of the important treatment methods for HCC， radiotherapy can effectively control the local growth of tumors and alleviate symptoms in patients. However， radiotherapy resistance seriously affects the treatment effect and has become a major challenge in clinical treatment. Current research shows a complex mechanism of radiotherapy resistance in HCC， involving multiple factors such as abnormal activation of intracellular signaling pathways， changes in tumor microenvironment， and regulation of gene expression. Therefore， a series of strategies have been proposed to address radiotherapy resistance in clinical practice， including regulating cell signaling pathways， improving tumor microenvironment， and combining different treatment modalities， and such strategies have shown promising application prospects. This article reviews the research advances in the mechanism of radiotherapy resistance and related coping strategies， in order to provide new perspectives for future research on radiotherapy for HCC.
- Carcinoma， Hepatocellular /
- Radiotherapy Resistance /
- Therapeutics

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注： GPx，谷胱甘肽过氧化物酶；SOD，超氧化物歧化酶；DNA-PKcs，DNA依赖性蛋白激酶催化亚基。

图 1 放疗后HCC细胞DNA损伤修复、细胞周期阻滞与凋亡逃逸的多重通路

Figure 1. Multiple pathways of DNA damage repair， cell cycle arrest， and evasion of apoptosis in hepatocellular carcinoma cells following radiotherapy

下载: 全尺寸图片幻灯片

注： PDGF，血小板衍生生长因子；GSH，谷胱甘肽。

图 2 放疗后TME中放射抵抗的形成机制

Figure 2. Mechanisms of radiation resistance formation in the tumor microenvironment following radiotherapy

下载: 全尺寸图片幻灯片

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