1. Biological Principles of Stereotactic Body Radiation Therapy (SBRT) and Stereotactic Radiation Surgery (SRS): Indirect Cell Death
- Author
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Chang W. Song, Jimm Grimm, Lawrence B. Marks, Eli Glatstein, Kathryn E. Dusenbery, Susanta K. Hui, Paul W. Sperduto, Bahman Emami, Mi-Sook Kim, and L. Chinsoo Cho
- Subjects
Organs at Risk ,Cancer Research ,medicine.medical_specialty ,Programmed cell death ,Radiobiology ,Cell Survival ,Stereotactic body radiation therapy ,Mice, Nude ,Immunogenic Cell Death ,Radiosurgery ,030218 nuclear medicine & medical imaging ,Mice ,03 medical and health sciences ,0302 clinical medicine ,Neoplasms ,parasitic diseases ,medicine ,Tumor cell death ,Animals ,Humans ,Radiology, Nuclear Medicine and imaging ,Carcinoma 256, Walker ,Radiation ,Cell Death ,Antitumor immunity ,business.industry ,Dose fractionation ,Xenograft Model Antitumor Assays ,Rats ,Surgery ,Oncology ,Stereotactic radiation ,030220 oncology & carcinogenesis ,Blood Vessels ,Tumor Hypoxia ,Immunogenic cell death ,Dose Fractionation, Radiation ,Endothelium, Vascular ,business ,DNA Damage - Abstract
Purpose To review the radiobiological mechanisms of stereotactic body radiation therapy stereotactic body radiation therapy (SBRT) and stereotactic radiation surgery (SRS). Methods and Materials We reviewed previous reports and recent observations on the effects of high-dose irradiation on tumor cell survival, tumor vasculature, and antitumor immunity. We then assessed the potential implications of these biological changes associated with SBRT and SRS. Results Irradiation with doses higher than approximately 10 Gy/fraction causes significant vascular injury in tumors, leading to secondary tumor cell death. Irradiation of tumors with high doses has also been reported to increase the antitumor immunity, and various approaches are being investigated to further elevate antitumor immunity. The mechanism of normal tissue damage by high-dose irradiation needs to be further investigated. Conclusions In addition to directly killing tumor cells, high-dose irradiation used in SBRT and SRS induces indirect tumor cell death via vascular damage and antitumor immunity. Further studies are warranted to better understand the biological mechanisms underlying the high efficacy of clinical SBRT and SRS and to further improve the efficacy of SBRT and SRS.
- Published
- 2021