Radiosensitizing_agent

Radiosensitizer

A radiosensitizer is an agent that makes tumor cells more sensitive to radiation therapy. It is sometimes also known as a radiation sensitizer or radio-enhancer.

Cisplatin, a platinum-based chemotherapeutic and radio sensitizer

Mechanism of action

Conventional chemotherapeutics are currently being used in conjunction with radiation therapy to increase its effectiveness. Examples include the fluoropyrimidines, gemcitabine and platinum analogs; fluoropyrimidines increase sensitivity by dysregulating S-phase cell cycle checkpoints in tumor cells. Gemcitabine progresses through a similar mechanism, causing cells in the S-phase to disrepair DNA damage caused by the radiation. Platinum analogs such as cisplatin inhibit DNA repair by cross linking strands, and so aggravate the effects of DNA damage induced by radiation.[1]

Limitations

One of the major limitations of radiotherapy is that the cells of solid tumors become deficient in oxygen. Solid tumors can outgrow their blood supply, causing a low-oxygen state known as hypoxia. Oxygen is a potent radiosensitizer, increasing the effectiveness of a given dose of radiation by forming DNA-damaging free radicals. Tumor cells in a hypoxic environment may be as much as 2 to 3 times more resistant to radiation damage than those in a normal oxygen environment.[2] Much research has been devoted to overcoming this problem including the use of high pressure oxygen tanks, blood substitutes that carry increased oxygen, hypoxic cell radiosensitizers such as misonidazole and metronidazole, and hypoxic cytotoxins, such as tirapazamine.

Drug development

As of September 2016, there are a number of radiosensitizers in clinical trials.

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References

  1. Lawrence, Theodore S.; Blackstock, A.William; McGinn, Cornelius (January 2003). "The mechanism of action of radiosensitization of conventional chemotherapeutic agents". Seminars in Radiation Oncology. 13 (1): 13–21. doi:10.1053/srao.2003.50002. PMID 12520460.
  2. Harrison LB, Chadha M, Hill RJ, Hu K, Shasha D (2002). "Impact of tumor hypoxia and anemia on radiation therapy outcomes". Oncologist. 7 (6): 492–508. doi:10.1634/theoncologist.7-6-492. PMID 12490737.
  3. "NanoXray video". nanobiotix.
  4. Gainer JL, Sheehan JP, Larner JM, Jones DR (2016). "Trans sodium crocetinate with temozolomide and radiation therapy for glioblastoma multiforme". Journal of Neurosurgery. 126 (2): 460–466. doi:10.3171/2016.3.JNS152693. PMID 27177177.

Public Domain This article incorporates public domain material from Dictionary of Cancer Terms. U.S. National Cancer Institute.


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