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2015 ; 141
(11
): 1985-94
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Radiation-induced fibrosis: mechanisms and implications for therapy
#MMPMID25910988
Straub JM
; New J
; Hamilton CD
; Lominska C
; Shnayder Y
; Thomas SM
J Cancer Res Clin Oncol
2015[Nov]; 141
(11
): 1985-94
PMID25910988
show ga
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.