代谢重编程是肿瘤细胞的重要特征之一。 肿瘤细胞通过改变自身的代谢模式来满足其对快速增殖所需要的能量 和代谢前体物质,并为各种生物大分子的合成提供原料。 与正常细胞相比,肿瘤细胞存在着大量的代谢异质性,从癌前病变 发展至局部浸润,出现转移或治疗抵抗,其代谢表型及代谢依赖性都可能发生改变。 放射治疗(简称放疗)是恶性肿瘤治疗的 重要手段,辐射抗性一直是限制放疗疗效的主要原因,也是目前抗肿瘤治疗研究的难点和热点。 肿瘤放疗抵抗与代谢重编程 密切相关。 肿瘤细胞特殊的有氧糖酵解模式造成了高乳酸的微环境,不利于射线发挥作用;代谢过程中抗氧化分子的积 累,可以保护肿瘤细胞免受自由基的辐射损伤;辐射下肿瘤细胞需要更多的能量供应以及生物大分子的合成来促进 DNA 损伤 修复,灵活的代谢方式转换为其提供了条件。 正常组织和恶性细胞之间代谢模式的差异为靶向代谢治疗提供了机会,本文就 肿瘤主要代谢途径与放疗的相互关系进行了综述,以望能够通过靶向代谢的方式逆转辐射抵抗,提高肿瘤放疗的敏感性。

Metabolic reprogramming is one of the important hallmark of cancer. To meet the anabolic demands of the proliferative potential of tumor cells malignant cells tend to rewire their metabolic pathways. Radiation therapy is an important means for the treatment of malignant tumors. Compared with normal cells tumor cells have a large amount of metabolic heterogeneity from the development of precancerous lesions to local invasion metastasis or treatment resistance the metabolic phenotype and metabolic dependence may change. Radiation resistance has always been the main reason for limiting the efficacy of radiation therapy and is also a difficult and hot spot in the research of anti - tumor therapy. Tumor radiotherapy resistance is closely related to metabolic reprogramming. The special aerobic glycolysis mode of tumor cells creates a high lactic acid microenvironment which is not conducive to the role of radiation The accumulation of antioxidant molecules during metabolism can protect tumor cells from radiation damage of free radicals Under irradiation tumor cells need more energy supply and the synthesis of biological macromolecules to promote DNA damage and repair and flexible metabolic mode conversion provides conditions for it. The difference of metabolic patterns between normal tissues and malignant cells provides an opportunity for targeted metabolic therapy. This article reviews the relationship between the main metabolic pathways of tumor and radiotherapy hoping to reverse the radiation resistance and improve the sensitivity of tumor radiotherapy through targeted metabolism.