Sarcomas are a heterogeneous group of bone and soft tissue tumors. Survival outcomes for advanced (unresectable or metastatic) disease remain poor, so therapeutic improvements are needed. Radiotherapy plays an integral role in the neoadjuvant and adjuvant treatment of localized disease as well as in the treatment of metastatic disease. Combining radiotherapy with immunotherapy to potentiate immunotherapy has been used in a variety of cancers other than sarcoma, and there is opportunity to further investigate combining immunotherapy with radiotherapy to try to improve outcomes in sarcoma. In this review, we describe the diversity of the tumor immune microenvironments for sarcomas and describe the immunomodulatory effects of radiotherapy. We discuss studies on the timing of radiotherapy relative to immunotherapy and studies on the radiotherapy dose and fractionation regimen to be used in combination with immunotherapy. We describe the impact of radiotherapy on the tumor immune microenvironment. We review completed and ongoing clinical trials combining radiotherapy with immunotherapy for sarcoma and propose future directions for studies combining immunotherapy with radiotherapy in the treatment of sarcoma.

中文翻译：

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肉瘤的免疫疗法和放射疗法组合

肉瘤是一组异质性骨和软组织肿瘤。晚期（不可切除或转移性）疾病的生存结果仍然很差，因此需要改进治疗方法。放射治疗在局部疾病的新辅助和辅助治疗以及转移性疾病的治疗中发挥着不可或缺的作用。放疗与免疫疗法相结合以增强免疫疗法已用于肉瘤以外的多种癌症，并且有机会进一步研究免疫疗法与放疗相结合，以尝试改善肉瘤的预后。在这篇综述中，我们描述了肉瘤肿瘤免疫微环境的多样性，并描述了放射治疗的免疫调节作用。我们讨论了与免疫治疗相关的放射治疗时机的研究，以及与免疫治疗联合使用的放射治疗剂量和分割方案的研究。我们描述了放疗对肿瘤免疫微环境的影响。我们回顾了已完成和正在进行的肉瘤放疗与免疫疗法相结合的临床试验，并提出了免疫疗法与放疗相结合治疗肉瘤的研究的未来方向。