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Journal of Cancer Research and Clinical Oncology

Erschienen in:

01.11.2015 | Review – Clinical Oncology

Radiation-induced fibrosis: mechanisms and implications for therapy

verfasst von: Jeffrey M. Straub, Jacob New, Chase D. Hamilton, Chris Lominska, Yelizaveta Shnayder, Sufi M. Thomas

Erschienen in: Journal of Cancer Research and Clinical Oncology | Ausgabe 11/2015

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Abstract

Purpose

Radiation-induced fibrosis (RIF) is a long-term side effect of external beam radiation therapy for the treatment of cancer. It results in a multitude of symptoms that significantly impact quality of life. Understanding the mechanisms of RIF-induced changes is essential to developing effective strategies to prevent long-term disability and discomfort following radiation therapy. In this review, we describe the current understanding of the etiology, clinical presentation, pathogenesis, treatment, and directions of future therapy for this condition.

Methods

A literature review of publications describing mechanisms or treatments of RIF was performed. Specific databases utilized included PubMed and clinicaltrials.gov, using keywords “Radiation-Induced Fibrosis,” “Radiotherapy Complications,” “Fibrosis Therapy,” and other closely related terms.

Results

RIF is the result of a misguided wound healing response. In addition to causing direct DNA damage, ionizing radiation generates reactive oxygen and nitrogen species that lead to localized inflammation. This inflammatory process ultimately evolves into a fibrotic one characterized by increased collagen deposition, poor vascularity, and scarring. Tumor growth factor beta serves as the primary mediator in this response along with a host of other cytokines and growth factors. Current therapies have largely been directed toward these molecular targets and their associated signaling pathways.

Conclusion

Although RIF is widely prevalent among patients undergoing radiation therapy and significantly impacts quality of life, there is still much to learn about its pathogenesis and mechanisms. Current treatments have stemmed from this understanding, and it is anticipated that further elucidation will be essential for the development of more effective therapies.

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Titel: Radiation-induced fibrosis: mechanisms and implications for therapy
verfasst von: Jeffrey M. Straub
Jacob New
Chase D. Hamilton
Chris Lominska
Yelizaveta Shnayder
Sufi M. Thomas
Publikationsdatum: 01.11.2015
Verlag: Springer Berlin Heidelberg
Erschienen in: Journal of Cancer Research and Clinical Oncology / Ausgabe 11/2015
Print ISSN: 0171-5216
Elektronische ISSN: 1432-1335
DOI: https://doi.org/10.1007/s00432-015-1974-6

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Radiation-induced fibrosis: mechanisms and implications for therapy