Strategies to optimize radiotherapy based on biological responses of tumor and normal tissue (Review)

Wang,Weidong; Lang,Jinyi

doi:10.3892/etm.2012.593

Strategies to optimize radiotherapy based on biological responses of tumor and normal tissue (Review)

Authors:
- Weidong Wang
- Jinyi Lang
View Affiliations

Affiliations: Department of Radiation Oncology, Sichuan Cancer Hospital, Chengdu 610041, P.R. China
Published online on: May 30, 2012 https://doi.org/10.3892/etm.2012.593
Pages: 175-180

Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )

Metrics: Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )

Cited By (CrossRef): 0 citations Loading Articles...

Abstract

Rapid developments in radiation oncology are currently taking place. Radiation-induced responses are being increasingly used for radiotherapy modification based on advancements in radiobiology. In the process of radiation treatment, radiobiological responses of tumor and normal tissue in patients are monitored non-invasively by a variety of techniques including imaging, biological methods and biochemical assays. Information collected using these methods and data on responses are further incorporated into radiotherapy optimization approaches, which not only include the optimization of radiation treatment planning, such as dose distributions in targets and treatment delivery, but also include radiation sensitivity modification and gene radiotherapy of the tumor and normal tissue. Hence, the highest tumor control rate is obtained with the utmost protection being afforded to normal tissue under this treatment modality.

View Figures

View References

1.	Jaffray D, Kupelian P, Djemil T and Macklis RM: Review of image-guided radiation therapy. Expert Rev Anticancer Ther. 7:89–103. 2007. View Article : Google Scholar
2.	Eke I and Cordes N: Radiobiology goes 3D: how ECM and cell morphology impact on cell survival after irradiation. Radiother Oncol. 99:271–278. 2011. View Article : Google Scholar : PubMed/NCBI
3.	Bortfeld T and Jeraj R: The physical basis and future of radiation therapy. Br J Radiol. 84:485–498. 2011. View Article : Google Scholar
4.	Hunter KU and Eisbruch A: Advances in imaging: target delineation. Cancer J. 17:151–154. 2011. View Article : Google Scholar : PubMed/NCBI
5.	Begg AC, Stewart FA and Vens C: Strategies to improve radiotherapy with targeted drugs. Nat Rev Cancer. 11:239–253. 2011. View Article : Google Scholar : PubMed/NCBI
6.	Bhide SA and Nutting CM: Recent advances in radiotherapy. BMC Med. 8:252010. View Article : Google Scholar
7.	Chen GT, Sharp GC and Mori S: A review of image-guided radiotherapy. Radiol Phys Technol. 2:1–12. 2009. View Article : Google Scholar
8.	Okunieff P, Chen Y, Maguire DJ and Huser AK: Molecular markers of radiation-related normal tissue toxicity. Cancer Metastasis Rev. 27:363–374. 2008. View Article : Google Scholar : PubMed/NCBI
9.	Galbán S, Brisset JC, Rehemtulla A, Chenevert TL, Ross BD and Galbán CJ: Diffusion-weighted MRI for assessment of early cancer treatment response. Curr Pharm Biotechnol. 11:701–708. 2010.PubMed/NCBI
10.	Thoeny HC and Ross BD: Predicting and monitoring cancer treatment response with diffusion-weighted MRI. J Magn Reson Imaging. 32:2–16. 2010. View Article : Google Scholar : PubMed/NCBI
11.	Verellen D, Depuydt T, Gevaert T, Linthout N, Tournel K, Duchateau M, Reynders T, Storme G and De Ridder M: Gating and tracking, 4D in thoracic tumours. Cancer Radiother. 14:446–454. 2010. View Article : Google Scholar : PubMed/NCBI
12.	Zaider M and Hanin L: Tumor control probability in radiation treatment. Med Phys. 38:574–583. 2011. View Article : Google Scholar : PubMed/NCBI
13.	Bentzen SM and Gregoire V: Molecular imaging-based dose painting: a novel paradigm for radiation therapy prescription. Semin Radiat Oncol. 21:101–110. 2011. View Article : Google Scholar : PubMed/NCBI
14.	Mladenov E and Iliakis G: Induction and repair of DNA double strand breaks: The increasing spectrum of non-homologous end joining pathways. Mutat Res. 711:61–72. 2011. View Article : Google Scholar : PubMed/NCBI
15.	Bekker-Jensen S and Mailand N: Assembly and function of DNA double-strand break repair foci in mammalian cells. DNA Repair. 9:1219–1228. 2010. View Article : Google Scholar : PubMed/NCBI
16.	Thoms J and Bristow RG: DNA repair targeting and radiotherapy: a focus on the therapeutic ratio. Semin Radiat Oncol. 20:217–222. 2010. View Article : Google Scholar : PubMed/NCBI
17.	Orlowski C, Mah LJ, Vasireddy RS, El-Osta A and Karagiannis TC: Double-strand breaks and the concept of short-and long-term epigenetic memory. Chromosoma. 120:129–149. 2011. View Article : Google Scholar : PubMed/NCBI
18.	Eccles LJ, O’Neill P and Lomax ME: Delayed repair of radiation induced clustered DNA damage: friend or foe? Mutat Res. 711:134–141. 2011. View Article : Google Scholar : PubMed/NCBI
19.	Smith J, Tho LM, Xu N and Gillespie DA: The ATM-Chk2 and ATR-Chk1 pathways in DNA damage signaling and cancer. Adv Cancer Res. 108:73–112. 2010. View Article : Google Scholar : PubMed/NCBI
20.	Olcina M, Lecane PS and Hammond EM: Targeting hypoxic cells through the DNA damage response. Clin Cancer Res. 16:5624–5629. 2010. View Article : Google Scholar : PubMed/NCBI
21.	Dobbs TA, Tainer JA and Lees-Miller SP: A structural model for regulation of NHEJ by DNA-PKcs autophosphorylation. DNA Repair. 9:1307–1314. 2010. View Article : Google Scholar : PubMed/NCBI
22.	Sun Y, Jiang X and Price BD: Tip60: connecting chromatin to DNA damage signaling. Cell Cycle. 99:30–36. 2010.PubMed/NCBI
23.	Xu Y and Price BD: Chromatin dynamics and the repair of DNA double strand breaks. Cell Cycle. 10:261–267. 2011. View Article : Google Scholar : PubMed/NCBI
24.	Tomita M: Involvement of DNA-PK and ATM in radiation- and heat-induced DNA damage recognition and apoptotic cell death. J Radiat Res (Tokyo). 51:493–501. 2010. View Article : Google Scholar : PubMed/NCBI
25.	Pawelczak KS, Bennett SM and Turchi JJ: Coordination of DNA-PK activation and nuclease processing of DNA termini in NHEJ. Antioxid Redox Signal. 14:2531–2543. 2011. View Article : Google Scholar : PubMed/NCBI
26.	Bischoff P, Altmeyer A and Dumont F: Radiosensitising agents for the radiotherapy of cancer: advances in traditional and hypoxia targeted radiosensitisers. Expert Opin Ther Pat. 19:643–662. 2009. View Article : Google Scholar : PubMed/NCBI
27.	Bussink J, Kaanders JH and van der Kogel AJ: Tumor hypoxia at the micro-regional level: clinical relevance and predictive value of exogenous and endogenous hypoxic cell markers. Radiother Oncol. 67:3–15. 2003. View Article : Google Scholar : PubMed/NCBI
28.	Rothkamm K and Horn S: gamma-H2AX as protein biomarker for radiation exposure. Ann Ist Super Sanita. 45:265–271. 2009.PubMed/NCBI
29.	Sak A and Stuschke M: Use of γH2AX and other biomarkers of double-strand breaks during radiotherapy. Semin Radiat Oncol. 20:223–231. 2010.
30.	Weichselbaum RR and Kufe D: Translation of the radio- and chemo-inducible TNFerade vector to the treatment of human cancers. Cancer Gene Ther. 16:609–619. 2009. View Article : Google Scholar : PubMed/NCBI
31.	Wyrobek AJ, Manohar CF, Krishnan VV, Nelson DO, Furtado MR, Bhattacharya MS, Marchetti F and Coleman MA: Low dose radiation response curves, networks and pathways in human lymphoblastoid cells exposed from 1 to 10 cGy of acute gamma radiation. Mutat Res. 722:119–130. 2011. View Article : Google Scholar : PubMed/NCBI
32.	Blankenberg FG and Norfray JF: Multimodality molecular imaging of apoptosis in oncology. Am J Roentgenol. 197:308–317. 2011. View Article : Google Scholar : PubMed/NCBI
33.	Rodriguez-Rocha H, Garcia-Garcia A, Panayiotidis MI and Franco R: DNA damage and autophagy. Mutat Res. 711:158–166. 2011. View Article : Google Scholar : PubMed/NCBI
34.	Chen S, Rehman SK, Zhang W, Wen A, Yao L and Zhang J: Autophagy is a therapeutic target in anticancer drug resistance. Biochim Biophys Acta. 1806:220–229. 2010.PubMed/NCBI
35.	Yoon JH, Ahn SG, Lee H, Jung SH and Oh SH: Role of autophagy in chemoresistance: regulation of the ATM-mediated DNA-damage signaling pathway through activation of DNA-PKcs and PARP-1. Biochem Pharmacol. 83:747–757. 2012. View Article : Google Scholar : PubMed/NCBI
36.	Hennequin C, Quero L and Favaudon V: Determinants and predictive factors of tumour radiosensitivity. Cancer Radiother. 12:3–13. 2008.
37.	Gravina GL, Festuccia C, Marampon F, Popov VM, Pestell RG, Zani BM and Tombolini V: Biological rationale for the use of DNA methyltransferase inhibitors as new strategy for modulation of tumor response to chemotherapy and radiation. Mol Cancer. 9:3052010. View Article : Google Scholar : PubMed/NCBI
38.	Pauwels B, Wouters A, Peeters M, Vermorken JB and Lardon F: Role of cell cycle perturbations in the combination therapy of chemotherapeutic agents and radiation. Future Oncol. 6:1485–1496. 2010. View Article : Google Scholar : PubMed/NCBI
39.	Takekawa M, Kubota Y, Nakamura T and Ichikawa K: Regulation of stress-activated MAP kinase pathways during cell fate decisions. Nagoya J Med Sci. 73:1–14. 2011.PubMed/NCBI
40.	Kim J, Meyer JL and Dawson LA: Image guidance and the new practice of radiotherapy: what to know and use from a decade of investigation. Front Radiat Ther Oncol. 43:196–216. 2011. View Article : Google Scholar : PubMed/NCBI
41.	Vral A, Fenech M and Thierens H: The micronucleus assay as a biological dosimeter of in vivo ionising radiation exposure. Mutagenesis. 26:11–17. 2011. View Article : Google Scholar : PubMed/NCBI
42.	Parliament MB and Murray D: Single nucleotide polymorphisms of DNA repair genes as predictors of radioresponse. Semin Radiat Oncol. 20:232–240. 2010. View Article : Google Scholar : PubMed/NCBI
43.	Baskar R: Emerging role of radiation induced bystander effects: Cell communications and carcinogenesis. Genome Integr. 1:132010. View Article : Google Scholar : PubMed/NCBI
44.	Cao Y: The promise of dynamic contrast-enhanced imaging in radiation therapy. Semin Radiat Oncol. 21:147–156. 2011. View Article : Google Scholar : PubMed/NCBI
45.	Yarnold J and Brotons MC: Pathogenetic mechanisms in radiation fibrosis. Radiother Oncol. 97:149–161. 2010. View Article : Google Scholar : PubMed/NCBI
46.	Heneweer C and Grimm J: Clinical applications in molecular imaging. Pediatr Radiol. 41:199–207. 2011. View Article : Google Scholar : PubMed/NCBI
47.	Müller K and Meineke V: Radiation-induced alterations in cytokine production by skin cells. Exp Hematol. 35(Suppl 1): 96–104. 2007.PubMed/NCBI
48.	Kong FM, Ao X, Wang L and Lawrence TS: The use of blood biomarkers to predict radiation lung toxicity: a potential strategy to individualize thoracic radiation therapy. Cancer Control. 15:140–150. 2008.PubMed/NCBI
49.	Deorukhkar A and Krishnan S: Targeting inflammatory pathways for tumor radiosensitization. Biochem Pharmacol. 80:1904–1914. 2010. View Article : Google Scholar : PubMed/NCBI
50.	Fritz G, Henninger C and Huelsenbeck J: Potential use of HMG-CoA reductase inhibitors (statins) as radioprotective agents. Br Med Bull. 97:17–26. 2011. View Article : Google Scholar : PubMed/NCBI
51.	Bussink J, van Herpen CM, Kaanders JH and Oyen WJ: PET-CT for response assessment and treatment adaptation in head and neck cancer. Lancet Oncol. 11:661–669. 2010. View Article : Google Scholar : PubMed/NCBI
52.	Castadot P, Lee JA, Geets X and Grégoire V: Adaptive radiotherapy of head and neck cancer. Semin Radiat Oncol. 20:84–93. 2010. View Article : Google Scholar
53.	Peng Q, Li J, Feng M, Xiao MY and Lang JY: A study of replanning during the course of IMRT for nasopharyngeal carcinoma. J Cancer Control Treat. 24:45–47. 2011.(In Chinese).
54.	Wang X, Lu JD, Xu XP, Zhu GP, Ying HM, He SQ, Hu WG and Hu CS: Anatomic and dosimetric changes during the treatment course of intensity-modulated radiotherapy for locally advanced nasopharyngeal carcinoma. Med Dosim. 35:151–157. 2010. View Article : Google Scholar
55.	Wang W, Yang H, Hu W, Shan G, Ding W, Yu C, Wang B, Wang X and Xu Q: Clinical study of the necessity of replanning before the 25th fraction during the course of intensity-modulated radiotherapy for patients with nasopharyngeal carcinoma. Int J Radiat Oncol Biol Phys. 77:617–621. 2010. View Article : Google Scholar : PubMed/NCBI
56.	Hansen KE, Bucci MK, Quivey JM, Weinberg V and Xia P: Repeat CT imaging and replanning during the course of IMRT for head-and-neck cancer. Int J Radiat Oncol Biol Phys. 64:355–362. 2006. View Article : Google Scholar : PubMed/NCBI
57.	Mechalakos J, Lee N, Hunt M, Ling CC and Amols HI: The effect of significant tumor reduction on the dose distribution in intensity modulated radiation therapy for head and neck cancer: a case study. Med Dosim. 34:250–255. 2009. View Article : Google Scholar : PubMed/NCBI
58.	Zhao L, Wan Q, Zhou Y, Deng X, Xie C and Wu S: The role of replanning in fractionated intensity modulated radiotherapy for nasopharyngeal carcinoma. Radiother Oncol. 98:23–27. 2011. View Article : Google Scholar : PubMed/NCBI
59.	Zhang Y and Li J: A study on necessity of radiotherapy replanning for non-small cell lung cancer. Int J Radiat Oncol Biol Phys. 78:S541–S542. 2010. View Article : Google Scholar
60.	Søvik A, Malinen E and Olsen DR: Strategies for biologic image-guided dose escalation: a review. Int J Radiat Oncol Biol Phys. 73:650–658. 2009.PubMed/NCBI
61.	Purdy JA: Dose to normal tissues outside the radiation therapy patient’s treated volume: a review of different radiation therapy techniques. Health Phys. 95:666–676. 2008.
62.	Guha C, Alfieri A, Blaufox MD and Kalnicki S: Tumor biology-guided radiotherapy treatment planning: gross tumor volume versus functional tumor volume. Semin Nucl Med. 38:105–113. 2008.PubMed/NCBI
63.	Thorwarth D and Schaefer A: Functional target volume delineation for radiation therapy on the basis of positron emission tomography and the correlation with histopathology. Q J Nucl Med Mol Imaging. 54:490–499. 2010.PubMed/NCBI
64.	Thorwarth D, Geets X and Paiusco M: Physical radiotherapy treatment planning based on functional PET/CT data. Radiother Oncol. 96:317–324. 2010. View Article : Google Scholar : PubMed/NCBI