Perfusion-Limited Hypoxia Determines the Outcome of Radiation Therapy of Hypoxic Tumours

Schiavo, Filippo; Toma-Daşu, Iuliana; Lindblom, Emely Kjellsson

doi:10.1007/978-3-031-14190-4_41

Cited by 3 publications

(1 citation statement)

References 12 publications

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“…Among the open issues is that the imaging resolution remains limited with respect to the tumor microenvironment. Differentiation between different forms of hypoxia (diffusion-limited, perfusion-limited, or anemic), which cannot yet be tackled with functional imaging techniques, was proven to be important [ 139 ] by employing tumor models with heterogeneous oxygenation [ 140 ]. Furthermore, pO 2 quantification is strongly affected by the choice of a well-oxygenated reference region and its assigned oxygenation level, which is used to normalize tracer uptake using conversion functions [ 141 ].…”

Section: Strategies To Maximize Carbon-ion Let and Their Limitationsmentioning

confidence: 99%

Carbon Ions for Hypoxic Tumors: Are We Making the Most of Them?

Sokol,

Durante

2023

Cancers

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Hypoxia, which is associated with abnormal vessel growth, is a characteristic feature of many solid tumors that increases their metastatic potential and resistance to radiotherapy. Carbon-ion radiation therapy, either alone or in combination with other treatments, is one of the most promising treatments for hypoxic tumors because the oxygen enhancement ratio decreases with increasing particle LET. Nevertheless, current clinical practice does not yet fully benefit from the use of carbon ions to tackle hypoxia. Here, we provide an overview of the existing experimental and clinical evidence supporting the efficacy of C-ion radiotherapy in overcoming hypoxia-induced radioresistance, followed by a discussion of the strategies proposed to enhance it, including different approaches to maximize LET in the tumors.

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Section: Strategies To Maximize Carbon-ion Let and Their Limitationsmentioning

confidence: 99%

Carbon Ions for Hypoxic Tumors: Are We Making the Most of Them?

Sokol,

Durante

2023

Cancers

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Hypoxia dose painting in SBRT – the virtual clinical trial approach

Schiavo,

Toma-Dasu,

Kjellsson Lindblom

2023

Acta Oncologica

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Potential Strategies for Overcoming Drug Resistance Pathways Using Propolis and Its Polyphenolic/Flavonoid Compounds in Combination with Chemotherapy and Radiotherapy

Oršolić,

Jazvinšćak Jembrek

2024

Nutrients

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Conventional cancer treatments include surgical resection, chemotherapy, hyperthermia, immunotherapy, hormone therapy, and locally targeted therapies such as radiation therapy. Standard cancer therapies often require the use of multiple agents, which can activate nuclear factor kappa B (NF-κB) in tumor cells, leading to reduced cell death and increased drug resistance. Moreover, the use of multiple agents also contributes to added toxicity, resulting in poor treatment outcomes. Cancer cells gradually develop resistance to almost all chemotherapeutics through various mechanisms, such as drug efflux, alterations in drug metabolism and transport, changes in signal transduction pathways, enhanced DNA repair capacity, evasion of apoptosis, increased mutations, reactivation of drug targets, interaction with the cancer microenvironment, cancer cell-stroma interactions, epithelial–mesenchymal transition (EMT)-mediated chemoresistance, epigenetic modifications, metabolic alterations, and the effect of cancer stem cells (CSCs). Developing new strategies to improve chemotherapy sensitivity while minimizing side effects is essential for achieving better therapeutic outcomes and enhancing patients’ quality of life. One promising approach involves combining conventional cancer treatments with propolis and its flavonoids. These natural compounds may enhance tumor response to treatment while reducing toxicity. Propolis and its components can sensitize cancer cells to chemotherapeutic agents, likely by inhibiting NF-κB activation, reprogramming tumor-associated macrophages (TAMs; an M2-like phenotype), and thereby reducing the release of matrix metalloproteinase (MMP)-9, cytokines, chemokines, and the vascular endothelial growth factor (VEGF). By reducing TAMs, propolis and its components may also overcome EMT-mediated chemoresistance, disrupt the crosstalk between macrophages and CSCs, inhibit the maintenance of stemness, and reverse acquired immunosuppression, thus promoting an antitumor response mediated by cytotoxic T-cells. This review highlights the potential of flavonoids to modulate the responsiveness of cancer to conventional treatment modalities. The evidence suggests that novel therapeutic strategies incorporating flavonoids could be developed to improve treatment outcomes. The positive effects of combining propolis with chemotherapeutics include reduced cytotoxicity to peripheral blood leukocytes, liver, and kidney cells. Therefore, polyphenolic/flavonoid components may hold potential for use in combination with chemotherapeutic agents in the clinical treatment of various types of cancers.

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Perfusion-Limited Hypoxia Determines the Outcome of Radiation Therapy of Hypoxic Tumours

Cited by 3 publications

References 12 publications

Carbon Ions for Hypoxic Tumors: Are We Making the Most of Them?

Carbon Ions for Hypoxic Tumors: Are We Making the Most of Them?

Hypoxia dose painting in SBRT – the virtual clinical trial approach

Potential Strategies for Overcoming Drug Resistance Pathways Using Propolis and Its Polyphenolic/Flavonoid Compounds in Combination with Chemotherapy and Radiotherapy

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