Prevention and treatment of radiotherapy-induced side effectsBarazzuol, L., Coppes, R. P. & van Luijk, P., 24-Jun-2020, In : Molecular oncology. 14, 7, p. 1538-1554 17 p.
Research output: Contribution to journal › Review article › Academic › peer-review
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.
|Number of pages||17|
|Early online date||10-Jun-2020|
|Publication status||Published - 24-Jun-2020|
- 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