Biological Principles of Stereotactic Body Radiation Therapy (SBRT) and Stereotactic Radiation Surgery (SRS): Indirect Cell Death

To review the radiobiological mechanisms of stereotactic body radiation therapy stereotactic body radiation therapy (SBRT) and stereotactic radiation surgery (SRS). We reviewed previous reports and recent observations on the effects of high-dose irradiation on tumor cell survival, tumor vasculature,...

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Published inInternational journal of radiation oncology, biology, physics Vol. 110; no. 1; pp. 21 - 34
Main Authors Song, Chang W., Glatstein, Eli, Marks, Lawrence B., Emami, Bahman, Grimm, Jimm, Sperduto, Paul W., Kim, Mi-Sook, Hui, Susanta, Dusenbery, Kathryn E., Cho, L. Chinsoo
Format Journal Article
LanguageEnglish
Published United States Elsevier Inc 01.05.2021
Subjects
APOPTOSIS
RADIOLOGY AND NUCLEAR MEDICINE
RADIOTHERAPY
REVIEWS
SURGERY
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Abstract To review the radiobiological mechanisms of stereotactic body radiation therapy stereotactic body radiation therapy (SBRT) and stereotactic radiation surgery (SRS). 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. 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. 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.
AbstractList To review the radiobiological mechanisms of stereotactic body radiation therapy stereotactic body radiation therapy (SBRT) and stereotactic radiation surgery (SRS).
To review the radiobiological mechanisms of stereotactic body radiation therapy stereotactic body radiation therapy (SBRT) and stereotactic radiation surgery (SRS). 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. 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. 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.
To review the radiobiological mechanisms of stereotactic body radiation therapy stereotactic body radiation therapy (SBRT) and stereotactic radiation surgery (SRS).PURPOSETo review the radiobiological mechanisms of stereotactic body radiation therapy stereotactic body radiation therapy (SBRT) and stereotactic radiation surgery (SRS).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.METHODS AND MATERIALSWe 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.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.RESULTSIrradiation 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.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.CONCLUSIONSIn 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.
Author Cho, L. Chinsoo
Sperduto, Paul W.
Kim, Mi-Sook
Song, Chang W.
Grimm, Jimm
Marks, Lawrence B.
Hui, Susanta
Dusenbery, Kathryn E.
Glatstein, Eli
Emami, Bahman
Author_xml – sequence: 1
  givenname: Chang W.
  surname: Song
  fullname: Song, Chang W.
  email: songx001@umn.edu
  organization: Department of Radiation Oncology, University of Minnesota Medical School, Minneapolis, Minnesota
– sequence: 2
  givenname: Eli
  surname: Glatstein
  fullname: Glatstein, Eli
  organization: Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania
– sequence: 3
  givenname: Lawrence B.
  surname: Marks
  fullname: Marks, Lawrence B.
  organization: Department of Radiation Oncology, University of North Carolina, Chapel Hill, North Carolina
– sequence: 4
  givenname: Bahman
  surname: Emami
  fullname: Emami, Bahman
  organization: Department of Radiation Oncology, Loyola University Medical Center, Chicago, Illinois
– sequence: 5
  givenname: Jimm
  surname: Grimm
  fullname: Grimm, Jimm
  organization: Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University, Baltimore, Maryland
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  givenname: Paul W.
  surname: Sperduto
  fullname: Sperduto, Paul W.
  organization: Minneapolis Radiation Oncology and Gamma Knife Center, University of Minnesota, Minneapolis, Minnesota
– sequence: 7
  givenname: Mi-Sook
  surname: Kim
  fullname: Kim, Mi-Sook
  organization: Department of Radiation Oncology, Korea Institute of Radiological & Medical Sciences, Seoul, Korea
– sequence: 8
  givenname: Susanta
  surname: Hui
  fullname: Hui, Susanta
  organization: Department of Radiation Oncology, University of Minnesota Medical School, Minneapolis, Minnesota
– sequence: 9
  givenname: Kathryn E.
  surname: Dusenbery
  fullname: Dusenbery, Kathryn E.
  organization: Department of Radiation Oncology, University of Minnesota Medical School, Minneapolis, Minnesota
– sequence: 10
  givenname: L. Chinsoo
  surname: Cho
  fullname: Cho, L. Chinsoo
  organization: Department of Radiation Oncology, University of Minnesota Medical School, Minneapolis, Minnesota
BackLink https://www.ncbi.nlm.nih.gov/pubmed/30836165$$D View this record in MEDLINE/PubMed
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RADIOLOGY AND NUCLEAR MEDICINE
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Title Biological Principles of Stereotactic Body Radiation Therapy (SBRT) and Stereotactic Radiation Surgery (SRS): Indirect Cell Death
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