Tumor hypoxia and radiotherapy: A major driver of resistance even for novel radiotherapy modalities

IF 12.1 1区 医学 Q1 ONCOLOGY Seminars in cancer biology Pub Date : 2023-11-29 DOI:10.1016/j.semcancer.2023.11.006
Claire Beckers , Martin Pruschy, Irene Vetrugno
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Abstract

Hypoxia in solid tumors is an important predictor of poor clinical outcome to radiotherapy. Both physicochemical and biological processes contribute to a reduced sensitivity of hypoxic tumor cells to ionizing radiation and hypoxia-related treatment resistances. A conventional low-dose fractionated radiotherapy regimen exploits iterative reoxygenation in between the individual fractions, nevertheless tumor hypoxia still remains a major hurdle for successful treatment outcome. The technological advances achieved in image guidance and highly conformal dose delivery make it nowadays possible to prescribe larger doses to the tumor as part of single high-dose or hypofractionated radiotherapy, while keeping an acceptable level of normal tissue complication in the co-irradiated organs at risk. However, we insufficiently understand the impact of tumor hypoxia to single high-doses of RT and hypofractionated RT. So-called FLASH radiotherapy, which delivers ionizing radiation at ultrahigh dose rates (> 40 Gy/sec), has recently emerged as an important breakthrough in the radiotherapy field to reduce normal tissue toxicity compared to irradiation at conventional dose rates (few Gy/min). Not surprisingly, oxygen consumption and tumor hypoxia also seem to play an intriguing role for FLASH radiotherapy. Here we will discuss the role of tumor hypoxia for radiotherapy in general and in the context of novel radiotherapy treatment approaches.

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肿瘤缺氧和放疗:即使是新的放疗方式也会产生耐药性的主要驱动因素。
实体肿瘤的缺氧是放射治疗临床预后不良的重要预测指标。物理化学和生物过程都有助于降低缺氧肿瘤细胞对电离辐射的敏感性和缺氧相关的治疗抗性。传统的低剂量分割放疗方案利用单个部分之间的反复再氧化,然而肿瘤缺氧仍然是成功治疗结果的主要障碍。在图像引导和高度适形剂量递送方面取得的技术进步,使得现在可以在单次高剂量或低分割放射治疗中对肿瘤开更大剂量的处方,同时在有风险的共照射器官中保持正常组织并发症的可接受水平。然而,我们对肿瘤缺氧对单次高剂量放射治疗和低分割放射治疗的影响了解不够。因此,所谓的FLASH放射治疗,以超高剂量率(> 40Gy/sec)提供电离辐射,最近成为放射治疗领域的重要突破,与常规剂量率(很少Gy/min)的辐射相比,可以降低正常组织的毒性。毫不奇怪,氧气消耗和肿瘤缺氧似乎也在FLASH放疗中起着有趣的作用。在这里,我们将讨论肿瘤缺氧在放射治疗中的作用,以及在新的放射治疗方法的背景下。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Seminars in cancer biology
Seminars in cancer biology 医学-肿瘤学
CiteScore
26.80
自引率
4.10%
发文量
347
审稿时长
15.1 weeks
期刊介绍: Seminars in Cancer Biology (YSCBI) is a specialized review journal that focuses on the field of molecular oncology. Its primary objective is to keep scientists up-to-date with the latest developments in this field. The journal adopts a thematic approach, dedicating each issue to an important topic of interest to cancer biologists. These topics cover a range of research areas, including the underlying genetic and molecular causes of cellular transformation and cancer, as well as the molecular basis of potential therapies. To ensure the highest quality and expertise, every issue is supervised by a guest editor or editors who are internationally recognized experts in the respective field. Each issue features approximately eight to twelve authoritative invited reviews that cover various aspects of the chosen subject area. The ultimate goal of each issue of YSCBI is to offer a cohesive, easily comprehensible, and engaging overview of the selected topic. The journal strives to provide scientists with a coordinated and lively examination of the latest developments in the field of molecular oncology.
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