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

Song, Chang W.; Glatstein, Eli; Marks, Lawrence B.; Emami, Bahman; Grimm, Jimm; Sperduto, Paul W.; Kim, Mi Sook; Song, Hui; Dusenbery, Kathryn E.; Cho, L. Chinsoo

doi:10.1016/j.ijrobp.2019.02.047

Cited by 114 publications

(111 citation statements)

References 61 publications

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“…Theoretically, SABR would induce DNA damage that was more difficult to repair and decrease tumour cell repopulation due to reduced overall treatment time, albeit with a cost from decreased inter-fraction cellular reassortment and reoxygenation. There is currently insufficient data to confidently propose a model by which SABR achieves such high efficacy (Moding et al, 2016;Song et al, 2019). Indeed, some authors argue that the improved local control seen with SABR purely results from a higher dose (Brown et al, 2013(Brown et al, , 2014.…”

Section: Discussion and Clinical Relevancementioning

confidence: 99%

“…Oxygen fixation -the making permanent of DNA damage induced by radiation, via the formation of irreparable peroxyl radicals. several days after irradiation (Song et al, 2019). Interestingly, the ceramide apoptotic pathway in the tumour vascular endothelium, activated with ablative radiation doses, is thought to be especially important (Garcia-Barros et al, 2003;Rao et al, 2014).…”

Section: Discussion and Clinical Relevancementioning

confidence: 99%

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Molecular Mechanisms of Radiation-Induced Cancer Cell Death: A Primer

Sia

Szmyd

Hau

et al. 2020

Front. Cell Dev. Biol.

231

173

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Radiation therapy (RT) is responsible for at least 40% of cancer cures, however treatment resistance remains a clinical problem. There have been recent advances in understanding the molecular mechanisms of radiation-induced cell death. The type of cell death after radiation depends on a number of factors including cell type, radiation dose and quality, oxygen tension, TP53 status, DNA repair capacity, cell cycle phase at time of radiation exposure, and the microenvironment. Mitotic catastrophe (a pathway preceding cell death that happens in mitosis or as a consequence of aberrant mitotic progression) is the primary context of radiation-induced cell death in solid cancers, although in a small subset of cancers such as haematopoietic malignancies, radiation results in immediate interphase apoptosis, occurring within hours after exposure. There is intense therapeutic interest in using stereotactic ablative body radiotherapy (SABR), a precise, high-dose form of RT given in a small number of fractions, to prime the immune system for cancer cell killing, but the optimal radiation dose and fractionation remain unclear. Additionally, promising novel radiosensitisers targeting the cell cycle and DNA repair pathways are being trialled. In the context of the increasing use of SABR and such novel agents in the clinic, we provide an updated primer on the major types of radiation-induced cell death, focussing on their molecular mechanisms, factors affecting their initiation, and their implications on immunogenicity.

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Section: Discussion and Clinical Relevancementioning

confidence: 99%

Section: Discussion and Clinical Relevancementioning

confidence: 99%

Molecular Mechanisms of Radiation-Induced Cancer Cell Death: A Primer

Sia

Szmyd

Hau

et al. 2020

Front. Cell Dev. Biol.

231

173

View full text Add to dashboard Cite

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“…23 Termed stereotactic radiosurgery (SRS), the technology was rapidly adopted for the treatment of brain tumours and was used as a non-invasive outpatient procedure with short recovery times. 24 While initially restricted to the brain by limited technological capability to accurately target and account for physiologic motion, advancements in imaging, treatment planning and radiation delivery systems have allowed the same technology to be adapted for treatment of tumours throughout the body in a technique called stereotactic body radiation therapy (SBRT). 25 SBRT has also been used clinically to treat numerous benign conditions, including keloids, heterotopic ossification and trigeminal neuralgia.…”

Section: Historical Background To Stereotactic Radioablationmentioning

confidence: 99%

“…There is growing evidence that SBRT also works through additional indirect mechanisms owing to the higher dose, mainly through damage to tissue vasculature, leading to cell hypoxia and necrosis. 24,31 To this end, radiation-induced vascular changes in tumours have been observed in the hours or days after treatment, and pre-clinical studies have shown additional cell death aside from the direct effects of radiation. 31,32 These mechanisms have not been fully elucidated and there remains controversy over their exact role in SBRT.…”

Section: Mechanism Of Tissue Injury and Pre-clinical Validationmentioning

confidence: 99%

Non-invasive Stereotactic Radioablation: A New Option for the Treatment of Ventricular Arrhythmias

Wei

Qian

Tedrow

et al. 2020

Arrhythm Electrophysiol Rev

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Ventricular tachycardia (VT) is associated with significant morbidity and mortality. Radiofrequency catheter ablation can be effective for the treatment of VT but it carries a high rate of recurrence often attributable to insufficient depth of penetration for reaching critical arrhythmogenic substrates. Stereotactic body radioablation (SBRT) is a commonly used technology developed for the non-invasive treatment of solid tumours. Recent evidence suggests that it can also be effective for the treatment of VT. It is a non-invasive procedure and it has the unique advantage of delivering ablative energy to any desired volume within the body to reach sites that are inaccessible with catheter ablation. This article summarises the pre-clinical studies that have formed the evidence base for SBRT in the heart, describes the clinical approaches for SBRT VT ablation and provides perspective on next steps for this new treatment modality.

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“…Letzterem wird ein größeres immunogenes Potenzial nachgesagt, was im Kontext von Immuntherapien ggf. zu einer Wirkverstärkung führen kann [3]. Da bei der SBRT die bei der Fraktionierung beschriebenen Reparatureffekte eher gering ausfallen, muss die SBRT sehr präzise, das heißt ausschließlich auf den makroskopischen Tumor beschränkt, verschrieben werden.…”

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Strahlentherapie spinaler Tumoren

Straube

Combs

2020

Die Wirbelsäule

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ZusammenfassungDie Behandlung maligner Erkrankungen der Wirbelsäule ist grundsätzlich multidiziplinär angelegt. In vielen Fällen wird daher nach einer Operation, in Einzelfällen auch neoadjuvant oder als Alternative zur Operation, eine Strahlentherapie diskutiert. Die vorliegende Arbeit soll die Möglichkeiten, die Wirksamkeit und auch die Grenzen der modernen Radioonkologie aufzeigen. Dabei werden die typischen Indikationen zur Strahlentherapie besprochen und die zu erwartende Prognose und evtl. auftretende Nebenwirkungen besprochen. Weiterhin wird auf die Wechselwirkungen zwischen der operativen Versorgung inklusive der verwendeten Implantate und der sich anschließenden Bestrahlung eingegangen.

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

Cited by 114 publications

References 61 publications

Molecular Mechanisms of Radiation-Induced Cancer Cell Death: A Primer

Molecular Mechanisms of Radiation-Induced Cancer Cell Death: A Primer

Non-invasive Stereotactic Radioablation: A New Option for the Treatment of Ventricular Arrhythmias

Strahlentherapie spinaler Tumoren

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