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Cytotoxic agents and radiation therapy: mechanisms of action and clinical applications

Published online by Cambridge University Press:  17 October 2014

Amanda Marrone  and
William T. Tran
Amanda Marrone*
Affiliation:
Department of Radiation Therapy, Royal Victoria Hospital, Barrie, ON, Canada
William T. Tran
Affiliation:
Department of Radiation Oncology, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
*
Correspondence to: Amanda Marrone, Department of Radiation Therapy, 201 Georgian Drive, The Royal Victoria Hospital, Barrie, L4M 6M2 ON, Canada. Tel: (705) 728 9802, Ext. 43425. E-mail: marronea@rvh.on.ca
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Abstract

Background

The combination of radiation therapy and chemotherapy is rooted in its ability to help achieve locoregional and systemic control, therefore increasing the overall disease-free survival of patients. Understanding the mechanistic actions of cytotoxic agents and their targets on the cell cycle, as well as the governing pharmacokinetic principles can improve treatment delivery. The adjuvant treatment setting can overcome barriers such as hypoxia and genetically driven treatment resistance.

Purpose

The purpose of this review is to present theoretical frameworks behind the chemoradiation paradigm and to describe current chemoradiation practices in radiation oncology.

Methodology

A review was conducted using the US National Library of Medicine, National Institutes of Health database (PubMed) using the following search keywords: chemoradiation, spatial cooperation, chemotherapeutic agents, pharmacokinetics, anti-vascular agents, tumour vasculature and tumour hypoxia.

Results and conclusions

Current research has reported several rationales for the beneficial combination of radiation and chemotherapy to eradicate oncological diseases. Mechanisms of action and biological approaches are showing that concurrent treatments, as well as novel agents such as anti-vascular and anti-angiogenic agents may benefit improved treatment outcomes by reducing micro hypoxic environments in tumours. In addition, chemotherapy administered in tandem with radiation enhances cell-killing effects by targeting the cell cycle.

Keywords

chemoradiationchemotherapeutic agentsspatial cooperationtumour hypoxiatumour vasculature
Type
Literature Reviews
Information
Journal of Radiotherapy in Practice , Volume 14 , Issue 1 , March 2015 , pp. 63 - 69
Copyright
© Cambridge University Press 2014 

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