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International Journal of Radiation Oncology*Biology*Physics
Article . 2024 . Peer-reviewed
License: CC BY
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Serveur académique lausannois
Article . 2024
License: CC BY
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Acute Hypoxia Does Not Alter Tumor Sensitivity to FLASH Radiation Therapy

Authors: Ron J. Leavitt; Aymeric Almeida; Veljko Grilj; Pierre Montay-Gruel; Céline Godfroid; Benoit Petit; Claude Bailat; +2 Authors

Acute Hypoxia Does Not Alter Tumor Sensitivity to FLASH Radiation Therapy

Abstract

Tumor hypoxia is a major cause of treatment resistance, especially to radiation therapy at conventional dose rate (CONV), and we wanted to assess whether hypoxia does alter tumor sensitivity to FLASH.We engrafted several tumor types (glioblastoma [GBM], head and neck cancer, and lung adenocarcinoma) subcutaneously in mice to provide a reliable and rigorous way to modulate oxygen supply via vascular clamping or carbogen breathing. We irradiated tumors using a single 20-Gy fraction at either CONV or FLASH, measured oxygen tension, monitored tumor growth, and sampled tumors for bulk RNAseq and pimonidazole analysis. Next, we inhibited glycolysis with trametinib in GBM tumors to enhance FLASH efficacy.Using various subcutaneous tumor models, and in contrast to CONV, FLASH retained antitumor efficacy under acute hypoxia. These findings show that in addition to normal tissue sparing, FLASH could overcome hypoxia-mediated tumor resistance. Follow-up molecular analysis using RNAseq profiling uncovered a FLASH-specific profile in human GBM that involved cell-cycle arrest, decreased ribosomal biogenesis, and a switch from oxidative phosphorylation to glycolysis. Glycolysis inhibition by trametinib enhanced FLASH efficacy in both normal and clamped conditions.These data provide new and specific insights showing the efficacy of FLASH in a radiation-resistant context, proving an additional benefit of FLASH over CONV.

Country
Switzerland
Keywords

Computer. Automation, Lung Neoplasms, Pyridones, Pyrimidinones, Cell Cycle Checkpoints, Carbon Dioxide, Radiation Tolerance, Oxidative Phosphorylation, Oxygen, Animals; Humans; Mice; Pyrimidinones/pharmacology; Pyrimidinones/therapeutic use; Tumor Hypoxia; Glioblastoma/radiotherapy; Glioblastoma/metabolism; Glycolysis; Pyridones/pharmacology; Pyridones/therapeutic use; Radiation Tolerance; Nitroimidazoles; Cell Line, Tumor; Lung Neoplasms/radiotherapy; Lung Neoplasms/pathology; Lung Neoplasms/metabolism; Head and Neck Neoplasms/radiotherapy; Cell Cycle Checkpoints/radiation effects; Oxidative Phosphorylation; Oxygen/metabolism; Carbon Dioxide, Mice, Nitroimidazoles, Head and Neck Neoplasms, Cell Line, Tumor, Animals, Humans, Tumor Hypoxia, Human medicine, Glioblastoma, Glycolysis

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    popularity
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    Top 10%
    influence
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    impulse
    This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
37
Top 10%
Top 10%
Top 1%
Green
hybrid