Hyperthermia: The Optimal Treatment to Overcome Radiation Resistant Hypoxia

Regions of low oxygenation (hypoxia) are a characteristic feature of solid tumors, and cells existing in these regions are a major factor influencing radiation resistance as well as playing a significant role in malignant progression. Consequently, numerous pre-clinical and clinical attempts have be...

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Veröffentlicht in:Cancers Jg. 11; H. 1; S. 60
Hauptverfasser: Elming, Pernille, Sørensen, Brita, Oei, Arlene, Franken, Nicolaas, Crezee, Johannes, Overgaard, Jens, Horsman, Michael
Format: Journal Article
Sprache:Englisch
Veröffentlicht: Switzerland MDPI AG 09.01.2019
MDPI
Schlagworte:
Blood flow
Clinical trials
DNA repair
Fever
Heat
Heat treatments
Hyperthermia
Hypoxia
Oxygen
Oxygenation
Radiation therapy
Review
Solid tumors
Tumors
hypoxia
hyperthermia
radiation therapy
ISSN:2072-6694, 2072-6694
Online-Zugang:Volltext
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Zusammenfassung:Regions of low oxygenation (hypoxia) are a characteristic feature of solid tumors, and cells existing in these regions are a major factor influencing radiation resistance as well as playing a significant role in malignant progression. Consequently, numerous pre-clinical and clinical attempts have been made to try and overcome this hypoxia. These approaches involve improving oxygen availability, radio-sensitizing or killing the hypoxic cells, or utilizing high LET (linear energy transfer) radiation leading to a lower OER (oxygen enhancement ratio). Interestingly, hyperthermia (heat treatments of 39–45 °C) induces many of these effects. Specifically, it increases blood flow thereby improving tissue oxygenation, radio-sensitizes via DNA repair inhibition, and can kill cells either directly or indirectly by causing vascular damage. Combining hyperthermia with low LET radiation can even result in anti-tumor effects equivalent to those seen with high LET. The various mechanisms depend on the time and sequence between radiation and hyperthermia, the heating temperature, and the time of heating. We will discuss the role these factors play in influencing the interaction between hyperthermia and radiation, and summarize the randomized clinical trials showing a benefit of such a combination as well as suggest the potential future clinical application of this combination.
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ISSN:2072-6694
2072-6694
DOI:10.3390/cancers11010060