The impact of intraoperative radiotherapy on breast cancer: focus on the levels of angiogenic factors

Abstract

Objective Angiogenesis is one of the hallmarks of cancers that is involved in tumor progression. Angiogenic factors induce the formation of new blood vessels and tumor extension, and finally reduce the survival of patients. Intraoperative radiotherapy (IORT), in which radiation is delivered to the tumor bed can kill cells and change tumor microenvironment. Here, we compared the impact of IORT on the levels of angiogenic factors in the blood and surgical wound fluids (SWF) of the breast cancer patients. Patients and methods Three hundred sixty patients, who had undergone breast-conserving surgery between 2013 and 2018, were enrolled in IORT and non-IORT groups non-randomly. Blood and drained wound fluid (WF) samples were collected from the patients before and after surgery, followed by quantification of the amounts of TGF-β, EGF, FGF, VEGF, and DLL4 in the patients using ELISA. Results Our results were indicative of significant differences between the pre-surgery and post-surgery serum levels of EGF, DLL4, and VEGF. Furthermore, ROC analyses showed that TGF-β and DLL4 can differentiate of the early-stage from late-stage of the disease. Interestingly, the rate of the death and recurrence was reduced in IORT group. Conclusions In summary, IORT is a safe and effective treatment that can affect angiogenic factors and improve the overall- and recurrence-free survival of breast cancer patients.

Contemporaneous Perioperative Inflammatory and Angiogenic Cytokine Profiles of Surgical Breast, Colorectal, and Prostate Cancer Patients: Clinical Implications

“…It is an angiogenic factor associated with aggressive phenotypes and poor patient prognosis through its paracrine action in the tumor microenvironment. Similar to other angiogenic factors, its significant decline in the postoperative period can be attributed to removing the tumor and associated stromal and endothelial cells involved in producing these factors [88,89]. Although we have not analyzed wound fluid, the local and elevated production of these angiogenic growth factors in the resected area may represent an essential mechanism for initiating the local recurrence of residual cancer.…”

The effect of tumor vascular remodeling and immune microenvironment activation induced by radiotherapy: quantitative evaluation with magnetic resonance/photoacoustic dual-modality imaging

“…In addition, angiogenesis is an important phenomenon in the progression of breast cancer and is mainly dominated by a variety of inflammatory factors. The level of angiogenic factors and subsequent angiogenesis may play a role in breast cancer metastasis and no recurrence or overall survival ( 12 ). Radiotherapy can prune but not completely destroy the vascular structure of the tumor ( 13 ), so that the distribution of blood vessels is more uniform, the interstitial pressure in the tumor tissue is reduced, and the oxygen content in the tumor tissue and the distribution of combined therapy drugs are maximized ( 14 ).…”