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Erschienen in: Clinical and Experimental Medicine 4/2019

16.07.2019 | Review Article

Radiation-induced lung injury: latest molecular developments, therapeutic approaches, and clinical guidance

verfasst von: Lina Lu, Chao Sun, Qiong Su, Yanbin Wang, Jia Li, Zhong Guo, Lihua Chen, Hong Zhang

Erschienen in: Clinical and Experimental Medicine | Ausgabe 4/2019

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Abstract

Cancer research has advanced throughout the years with respect to the personalization of the treatments and to targeting cancer-related molecular signatures on different organs. Still, the adverse events of the treatments such as radiotherapy are of high concern as they may increase the mortality rate due to their severity. With the improved efficiency of cancer treatments, patient survival has been increasing. Consequently, the number of patients with adverse effects from radiotherapy is also expected to increase in the forthcoming years. Therefore, approaches for personalized treatments include the elimination of adverse events and decreasing the toxicity in healthy tissues while increasing the efficiency of cancer cytotoxicity. In this context, this paper aims to discuss the recent advances in the field of thorax irradiation therapy and its related toxicities leading to radiation pneumonitis in cancer patients. Molecular mechanisms involved in the radiation-induced lung injury and approaches used to overcome this lung injury are discussed. The discourse covers approaches such as therapeutic administration of natural products, current and prospective radioprotective drugs, and applications of mesenchymal stem cells for radiation-induced lung injury.
Literatur
1.
Zurück zum Zitat Yahyapour R, Motevaseli E, Rezaeyan A, et al. Reduction–oxidation (redox) system in radiation-induced normal tissue injury: molecular mechanisms and implications in radiation therapeutics. Clin Transl Oncol. 2018;20(8):975–88.CrossRef Yahyapour R, Motevaseli E, Rezaeyan A, et al. Reduction–oxidation (redox) system in radiation-induced normal tissue injury: molecular mechanisms and implications in radiation therapeutics. Clin Transl Oncol. 2018;20(8):975–88.CrossRef
6.
Zurück zum Zitat Cao K, Lei X, Liu H, et al. Polydatin alleviated radiation-induced lung injury through activation of Sirt3 and inhibition of epithelial–mesenchymal transition. J Cell Mol Med. 2017;21(12):3264–76.CrossRef Cao K, Lei X, Liu H, et al. Polydatin alleviated radiation-induced lung injury through activation of Sirt3 and inhibition of epithelial–mesenchymal transition. J Cell Mol Med. 2017;21(12):3264–76.CrossRef
8.
Zurück zum Zitat Verma V, Simone C, Werner-Wasik M. Acute and late toxicities of concurrent chemoradiotherapy for locally-advanced non-small cell lung cancer. Cancers. 2017;9(9):120.CrossRef Verma V, Simone C, Werner-Wasik M. Acute and late toxicities of concurrent chemoradiotherapy for locally-advanced non-small cell lung cancer. Cancers. 2017;9(9):120.CrossRef
9.
Zurück zum Zitat Klein D, Steens J, Wiesemann A, et al. Mesenchymal stem cell therapy protects lungs from radiation-induced endothelial cell loss by restoring superoxide dismutase 1 expression. Antioxid Redox Signal. 2017;26(11):563–82.CrossRef Klein D, Steens J, Wiesemann A, et al. Mesenchymal stem cell therapy protects lungs from radiation-induced endothelial cell loss by restoring superoxide dismutase 1 expression. Antioxid Redox Signal. 2017;26(11):563–82.CrossRef
10.
Zurück zum Zitat Yahyapour R, Motevaseli E, Rezaeyan A, et al. Mechanisms of radiation bystander and non-targeted effects: implications to radiation carcinogenesis and radiotherapy. Curr Radiopharm. 2018;11(1):34–45.CrossRef Yahyapour R, Motevaseli E, Rezaeyan A, et al. Mechanisms of radiation bystander and non-targeted effects: implications to radiation carcinogenesis and radiotherapy. Curr Radiopharm. 2018;11(1):34–45.CrossRef
11.
Zurück zum Zitat Hall J, Jeggo PA, West C, et al. Ionizing radiation biomarkers in epidemiological studies—an update. Mutation Res Rev Mutation Res. 2017;771:59–84.CrossRef Hall J, Jeggo PA, West C, et al. Ionizing radiation biomarkers in epidemiological studies—an update. Mutation Res Rev Mutation Res. 2017;771:59–84.CrossRef
12.
Zurück zum Zitat Yahyapour R, Shabeeb D, Cheki M, et al. Radiation protection and mitigation by natural antioxidants and flavonoids: implications to radiotherapy and radiation disasters. Curr Mol Pharmacol. 2018;11(4):285–304.CrossRef Yahyapour R, Shabeeb D, Cheki M, et al. Radiation protection and mitigation by natural antioxidants and flavonoids: implications to radiotherapy and radiation disasters. Curr Mol Pharmacol. 2018;11(4):285–304.CrossRef
13.
Zurück zum Zitat Meziani L, Mondini M, Petit B, et al. CSF1R inhibition prevents radiation pulmonary fibrosis by depletion of interstitial macrophages. Eur Respir J. 2018;51(3):1702120.CrossRef Meziani L, Mondini M, Petit B, et al. CSF1R inhibition prevents radiation pulmonary fibrosis by depletion of interstitial macrophages. Eur Respir J. 2018;51(3):1702120.CrossRef
14.
Zurück zum Zitat Lee HJ Jr, Zeng J, Vesselle HJ, Patel SA, Rengan R, Bowen SR. Correlation of functional lung heterogeneity and dosimetry to radiation pneumonitis using perfusion SPECT/CT and FDG PET/CT imaging. Int J Radiat Oncol Biol Phys. 2018;102(4):1255–64.CrossRef Lee HJ Jr, Zeng J, Vesselle HJ, Patel SA, Rengan R, Bowen SR. Correlation of functional lung heterogeneity and dosimetry to radiation pneumonitis using perfusion SPECT/CT and FDG PET/CT imaging. Int J Radiat Oncol Biol Phys. 2018;102(4):1255–64.CrossRef
15.
Zurück zum Zitat Chia BSH, Master Z. Pitfalls in lung stereotactic body radiotherapy—a review of organ toxicities and dose constraints. J Xiangya Med. 2018;3. Chia BSH, Master Z. Pitfalls in lung stereotactic body radiotherapy—a review of organ toxicities and dose constraints. J Xiangya Med. 2018;3.
16.
Zurück zum Zitat Dhami G, Zeng J, Vesselle HJ, et al. Framework for radiation pneumonitis risk stratification based on anatomic and perfused lung dosimetry. Strahlenther Onkol. 2017;193(5):410–8.CrossRef Dhami G, Zeng J, Vesselle HJ, et al. Framework for radiation pneumonitis risk stratification based on anatomic and perfused lung dosimetry. Strahlenther Onkol. 2017;193(5):410–8.CrossRef
17.
Zurück zum Zitat Kim K, Lee J, Cho Y, et al. Predictive factors of symptomatic radiation pneumonitis in primary and metastatic lung tumors treated with stereotactic ablative body radiotherapy. Radiat Oncol J. 2017;35(2):163.CrossRef Kim K, Lee J, Cho Y, et al. Predictive factors of symptomatic radiation pneumonitis in primary and metastatic lung tumors treated with stereotactic ablative body radiotherapy. Radiat Oncol J. 2017;35(2):163.CrossRef
18.
Zurück zum Zitat Lu C, Lei Z, Wu H, Lu H. Evaluating risk factors of radiation pneumonitis after stereotactic body radiation therapy in lung tumor: meta-analysis of 9 observational studies. PLoS ONE. 2018;13(12):e0208637.CrossRef Lu C, Lei Z, Wu H, Lu H. Evaluating risk factors of radiation pneumonitis after stereotactic body radiation therapy in lung tumor: meta-analysis of 9 observational studies. PLoS ONE. 2018;13(12):e0208637.CrossRef
19.
Zurück zum Zitat Dess RT, Sun Y, Matuszak MM, et al. Cardiac events after radiation therapy: combined analysis of prospective multicenter trials for locally advanced non-small-cell lung cancer. J Clin Oncol. 2017;35(13):1395.CrossRef Dess RT, Sun Y, Matuszak MM, et al. Cardiac events after radiation therapy: combined analysis of prospective multicenter trials for locally advanced non-small-cell lung cancer. J Clin Oncol. 2017;35(13):1395.CrossRef
20.
Zurück zum Zitat Wang K, Eblan MJ, Deal AM, et al. Cardiac toxicity after radiotherapy for stage III non-small-cell lung cancer: pooled analysis of dose-escalation trials delivering 70 to 90 Gy. J Clin Oncol. 2017;35(13):1387.CrossRef Wang K, Eblan MJ, Deal AM, et al. Cardiac toxicity after radiotherapy for stage III non-small-cell lung cancer: pooled analysis of dose-escalation trials delivering 70 to 90 Gy. J Clin Oncol. 2017;35(13):1387.CrossRef
23.
Zurück zum Zitat MacVittie TJ, Gibbs A, Farese AM, et al. AEOL 10150 mitigates radiation-induced lung injury in the nonhuman primate: morbidity and mortality are administration schedule-dependent. Radiat Res. 2017;187(3):298–318.CrossRef MacVittie TJ, Gibbs A, Farese AM, et al. AEOL 10150 mitigates radiation-induced lung injury in the nonhuman primate: morbidity and mortality are administration schedule-dependent. Radiat Res. 2017;187(3):298–318.CrossRef
24.
Zurück zum Zitat Jain V, Berman A. Radiation pneumonitis: old problem, new tricks. Cancers. 2018;10(7):222.CrossRef Jain V, Berman A. Radiation pneumonitis: old problem, new tricks. Cancers. 2018;10(7):222.CrossRef
27.
Zurück zum Zitat Haddadi GH, Rezaeyan A, Mosleh-Shirazi MA, et al. Hesperidin as radioprotector against radiation-induced lung damage in rat: a histopathological study. J Med Phys. 2017;42(1):25.CrossRef Haddadi GH, Rezaeyan A, Mosleh-Shirazi MA, et al. Hesperidin as radioprotector against radiation-induced lung damage in rat: a histopathological study. J Med Phys. 2017;42(1):25.CrossRef
28.
Zurück zum Zitat Najafi M, Shirazi A, Motevaseli E, Rezaeyan A, Salajegheh A, Rezapoor S. Melatonin as an anti-inflammatory agent in radiotherapy. Inflammopharmacology. 2017;25(4):403–13.CrossRef Najafi M, Shirazi A, Motevaseli E, Rezaeyan A, Salajegheh A, Rezapoor S. Melatonin as an anti-inflammatory agent in radiotherapy. Inflammopharmacology. 2017;25(4):403–13.CrossRef
29.
Zurück zum Zitat Ghobadi A, Shirazi A, Najafi M, Kahkesh MH, Rezapoor S. Melatonin ameliorates radiation-induced oxidative stress at targeted and nontargeted lung tissue. J Med Phys. 2017;42(4):241.CrossRef Ghobadi A, Shirazi A, Najafi M, Kahkesh MH, Rezapoor S. Melatonin ameliorates radiation-induced oxidative stress at targeted and nontargeted lung tissue. J Med Phys. 2017;42(4):241.CrossRef
30.
Zurück zum Zitat Pan J, Li D, Xu Y, et al. Inhibition of Bcl-2/xl with ABT-263 selectively kills senescent type II pneumocytes and reverses persistent pulmonary fibrosis induced by ionizing radiation in mice. Int J Radiat Oncol Biol Phys. 2017;99(2):353–61.CrossRef Pan J, Li D, Xu Y, et al. Inhibition of Bcl-2/xl with ABT-263 selectively kills senescent type II pneumocytes and reverses persistent pulmonary fibrosis induced by ionizing radiation in mice. Int J Radiat Oncol Biol Phys. 2017;99(2):353–61.CrossRef
33.
Zurück zum Zitat Small W, James JL, Moore TD, et al. Utility of the ACE inhibitor captopril in mitigating radiation-associated pulmonary toxicity in lung cancer. Am J Clin Oncol. 2018;41(4):396–401.PubMedPubMedCentral Small W, James JL, Moore TD, et al. Utility of the ACE inhibitor captopril in mitigating radiation-associated pulmonary toxicity in lung cancer. Am J Clin Oncol. 2018;41(4):396–401.PubMedPubMedCentral
35.
Zurück zum Zitat Moran A, Daly ME, Yip SS, Yamamoto T. Radiomics-based assessment of radiation-induced lung injury after stereotactic body radiotherapy. Clin Lung Cancer. 2017;18(6):e425–31.CrossRef Moran A, Daly ME, Yip SS, Yamamoto T. Radiomics-based assessment of radiation-induced lung injury after stereotactic body radiotherapy. Clin Lung Cancer. 2017;18(6):e425–31.CrossRef
37.
Zurück zum Zitat Lao CD, Ruffin MT, Normolle D, et al. Dose escalation of a curcuminoid formulation. BMC Complement Altern Med. 2006;6(1):10.CrossRef Lao CD, Ruffin MT, Normolle D, et al. Dose escalation of a curcuminoid formulation. BMC Complement Altern Med. 2006;6(1):10.CrossRef
38.
Zurück zum Zitat Verma V. Relationship and interactions of curcumin with radiation therapy. World J Clin Oncol. 2016;7(3):275.CrossRef Verma V. Relationship and interactions of curcumin with radiation therapy. World J Clin Oncol. 2016;7(3):275.CrossRef
39.
Zurück zum Zitat Lissoni P, Meregalli S, Nosetto L, et al. Increased survival time in brain glioblastomas by a radioneuroendocrine strategy with radiotherapy plus melatonin compared to radiotherapy alone. Oncology. 1996;53(1):43–6.CrossRef Lissoni P, Meregalli S, Nosetto L, et al. Increased survival time in brain glioblastomas by a radioneuroendocrine strategy with radiotherapy plus melatonin compared to radiotherapy alone. Oncology. 1996;53(1):43–6.CrossRef
40.
Zurück zum Zitat Ben-David MA, Elkayam R, Gelernter I, Pfeffer RM. Melatonin for prevention of breast radiation dermatitis: a phase II, prospective, double-blind randomized trial. Isr Med Assoc J. 2016;18(3–4):188–92.PubMed Ben-David MA, Elkayam R, Gelernter I, Pfeffer RM. Melatonin for prevention of breast radiation dermatitis: a phase II, prospective, double-blind randomized trial. Isr Med Assoc J. 2016;18(3–4):188–92.PubMed
41.
Zurück zum Zitat Wasserman TH, Brizel DM. The role of amifostine as a radioprotector. Oncol Williston Park Then Huntington. 2001;15(10):1349–56. Wasserman TH, Brizel DM. The role of amifostine as a radioprotector. Oncol Williston Park Then Huntington. 2001;15(10):1349–56.
42.
Zurück zum Zitat Phillips TL. Rationale for initial clinical trials and future development of radioprotectors. Cancer Clin Trials. 1980;3(2):165–73.PubMed Phillips TL. Rationale for initial clinical trials and future development of radioprotectors. Cancer Clin Trials. 1980;3(2):165–73.PubMed
43.
Zurück zum Zitat Citrin D, Cotrim AP, Hyodo F, Baum BJ, Krishna MC, Mitchell JB. Radioprotectors and mitigators of radiation-induced normal tissue injury. Oncologist. 2010;15(4):360–71.CrossRef Citrin D, Cotrim AP, Hyodo F, Baum BJ, Krishna MC, Mitchell JB. Radioprotectors and mitigators of radiation-induced normal tissue injury. Oncologist. 2010;15(4):360–71.CrossRef
Metadaten
Titel
Radiation-induced lung injury: latest molecular developments, therapeutic approaches, and clinical guidance
verfasst von
Lina Lu
Chao Sun
Qiong Su
Yanbin Wang
Jia Li
Zhong Guo
Lihua Chen
Hong Zhang
Publikationsdatum
16.07.2019
Verlag
Springer International Publishing
Erschienen in
Clinical and Experimental Medicine / Ausgabe 4/2019
Print ISSN: 1591-8890
Elektronische ISSN: 1591-9528
DOI
https://doi.org/10.1007/s10238-019-00571-w

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