Tumor hypoxia and reoxygenation : the yin and yang for radiotherapy

• 발행기관: 대한방사선종양학회
• 저자명: Beom Ju Hong Jeongwoo Kim Hoibin Jeong Seoyeon Bok Young Eun Kim G One Ahn
• 간행물 정보: 『대한방사선종양학회지』제34권 제4호, 239~249쪽, 전체 11쪽
• 주제분류: 의약학 > 종양학
• 파일형태: PDF
• 발행일자: 2016.12.30

영문 초록

Tumor hypoxia, a common feature occurring in nearly all human solid tumors is a major contributing factor for failures of anticancer therapies. Because ionizing radiation depends heavily on the presence of molecular oxygen to produce cytotoxic effect, the negative impact of tumor hypoxia had long been recognized. In this review, we will highlight some of the past attempts to overcome tumor hypoxia including hypoxic radiosensitizers and hypoxia-selective cytotoxin. Although they were (still are) a very clever idea, they lacked clinical efficacy largely because of ‘reoxygenation’ phenomenon occurring in the conventional low dose hyperfractionation radiotherapy prevented proper activation of these compounds. Recent meta-analysis and imaging studies do however indicate that there may be a significant clinical benefit in lowering the locoregional failures by using these compounds. Latest technological advancement in radiotherapy has allowed to deliver high doses of radiation conformally to the tumor volume. Although this technology has brought superb clinical responses for many types of cancer, recent modeling studies have predicted that tumor hypoxia is even more serious because ‘reoxygenation’ is low thereby leaving a large portion of hypoxic tumor cells behind. Wouldn’t it be then reasonable to combine hypoxic radiosensitizers and/or hypoxia-selective cytotoxin with the latest radiotherapy? We will provide some preclinical and clinical evidence to support this idea hoping to revamp an enthusiasm for hypoxic radiosensitizers or hypoxia-selective cytotoxins as an adjunct therapy for radiotherapy.

목차

Abstract

Introduction

Past Attempts with Hypoxic Radiosensitizers

Hypoxia Imaging-Important Lessons We Have Recently Learned from 18F-MISO and Tirapazamine

Recent Advances in Radiotherapy Technologies

Tumor Hypoxia with SBRT-Back to Square One?

Future Perspectives

Conclusions

Conflict of Interest

Acknowledgments

References

키워드

Hypoxia Radiosensitizers Hypoxia-selective cytotoxin Reoxygenation Hyperfractionation Hypofractionation