Biological consequences of cancer radiotherapy in the context of oral squamous cell carcinoma

Approximately 50% of subjects with cancer have been treated with ionizing radiation (IR) either as a curative, adjuvant, neoadjuvant or as a palliative agent, at some point during the clinical course of their disease. IR kills cancer cells directly by injuring their DNA, and indirectly by inducing i...

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Bibliographic Details
Published in:Head & face medicine 2021-08, Vol.17 (1), p.1-35, Article 35
Main Authors: Feller, G, Khammissa, R. A. G, Nemutandani, M. S, Feller, L
Format: Article
Language:English
Subjects:
Apoptosis
Bystander effect
Cancer
Casualties
Cell growth
Dentistry
Development and progression
DNA damage
Extracellular matrix
Free radicals
Gamma rays
Gene expression
Immune checkpoint inhibitors
Immune response
Immunogenic cell killing
Ionizing radiation
Metastasis
Oral cancer
Radiation
Radiation therapy
Radiotherapy
Review
Squamous cell carcinoma
Stem cells
T cells
Transcription factors
Tumour immunity
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Summary:Approximately 50% of subjects with cancer have been treated with ionizing radiation (IR) either as a curative, adjuvant, neoadjuvant or as a palliative agent, at some point during the clinical course of their disease. IR kills cancer cells directly by injuring their DNA, and indirectly by inducing immunogenic cell killing mediated by cytotoxic T cells; but it can also induce harmful biological responses to non-irradiated neighbouring cells (bystander effect) and to more distant cells (abscopal effect) outside the primary tumour field of irradiation. Although IR can upregulate anti-tumour immune reactions, it can also promote an immunosuppressive tumour microenvironment. Consequently, radiotherapy by itself is seldom sufficient to generate an effective long lasting immune response that is capable to control growth of metastasis, recurrence of primary tumours and development of second primary cancers. Therefore, combining radiotherapy with the use of immunoadjuvants such as immune checkpoint inhibitors, can potentiate IR-mediated anti-tumour immune reactions, bringing about a synergic immunogenic cell killing effect. The purpose of this narrative review is to discuss some aspects of IR-induced biological responses, including factors that contributes to tumour radiosensitivity/radioresistance, immunogenic cell killing, and the abscopal effect.
ISSN:1746-160X
1746-160X
DOI:10.1186/s13005-021-00286-y