Prevention and treatment of radiotherapy-induced side effects

Lara Barazzuol, Rob P Coppes*, Peter van Luijk

*Corresponding author for this work

    Research output: Contribution to journalReview articlepeer-review

    130 Citations (Scopus)
    292 Downloads (Pure)

    Abstract

    Radiotherapy remains a mainstay of cancer treatment, being used in roughly 50% of patients. The precision with which the radiation dose can be delivered is rapidly improving. This precision allows the more accurate targeting of radiation dose to the tumor and reduces the amount of surrounding normal tissue exposed. Although this often reduces the unwanted side effects of radiotherapy, we still need to further improve patients' quality of life and to escalate radiation doses to tumors when necessary. High-precision radiotherapy forces one to choose which organ or functional organ substructures should be spared. To be able to make such choices, we urgently need to better understand the molecular and physiological mechanisms of normal tissue responses to radiotherapy. Currently, oversimplified approaches using constraints on mean doses, and irradiated volumes of normal tissues are used to plan treatments with minimized risk of radiation side effects. In this review, we discuss the responses of three different normal tissues to radiotherapy: the salivary glands, cardiopulmonary system, and brain. We show that although they may share very similar local cellular processes, they respond very differently through organ-specific, nonlocal mechanisms. We also discuss how a better knowledge of these mechanisms can be used to treat or to prevent the effects of radiotherapy on normal tissue and to optimize radiotherapy delivery.

    Original languageEnglish
    Pages (from-to)1538-1554
    Number of pages17
    JournalMolecular oncology
    Volume14
    Issue number7
    Early online date10-Jun-2020
    DOIs
    Publication statusPublished - 24-Jun-2020

    Keywords

    • brain
    • cardiopulmonary system
    • dose distribution
    • normal tissue effects
    • salivary gland
    • CENTRAL-NERVOUS-SYSTEM
    • RADIATION-INDUCED APOPTOSIS
    • SALIVARY-GLAND FUNCTION
    • STEM-CELLS
    • PAROTID-GLAND
    • GROWTH-FACTOR
    • NORMAL TISSUE
    • CELLULAR SENESCENCE
    • POTENTIAL ROLE
    • INDUCED DAMAGE

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