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Potential of reducing normal tissue complications, using anti-angiogenic drugs in combination with radiotherapy-Modelling effects of improved tumor oxygenation

Poster (konferens)
Författare Jakob Heydorn Lagerlöf
Peter Bernhardt
Publicerad i Society of Nuclear Medicine Annual Meeting Abstracts 2009
Volym 50
Nummer/häfte 2
Sidor 1856
ISSN 0161-5505
Publiceringsår 2009
Publicerad vid Institutionen för kliniska vetenskaper, Avdelningen för radiofysik
Sidor 1856
Språk en
Ämnesord Oxygenation, Tumor control probability, Radionuclide therapy
Ämneskategorier Strålningsbiologi, Radiofysik, Cancer och onkologi

Sammanfattning

Objectives: Tumors stimulate angiogenesis, leading to increased interstitial pressure (IP) and degraded oxygenation (pO2) of the cells. In radiotherapy, high oxygen level in the tumor cells is favourable for successful treatment. Anti-angiogenic drugs can lower the IP in the tumor and cause improved perfusion and increased radionuclide uptake and pO2. This study aims to create a model, describing the variation and effects of altered tumor pO2 distribution due to anti-angiogenic treatment, for use within the field of radiation and radionuclide therapy. Methods: Based on experimental data (Lee et al., 2000), describing the effects of anti-angiogenic agents on pO2 in a tumor, a model was developed, showing how the treatment response improves as the tumor oxygenation level approaches that of normal tissue, which would be the theoretical maximum. The major difference occurs in the poorly oxygenated parts of the tumor. This is also the region where the pO2-dependence of the oxygen enhancement ratio is maximal. The dose levels required to achieve a tumor control probability (TCP) of 0.99 are compared for different pO2 distributions. The normal tissue doses will, in turn, depend on this. Results: As the distribution of oxygen in the tumor approaches normal tissue levels, the therapeutic effect on the tumor is improved so that the doses to normal tissue can be significantly decreased while retaining a high TCP. Conclusions: This shows the potential of efficient anti-angiogenic drugs, a potential that is likely to be further improved by the synergetic effects of an increased radionuclide uptake, in the field of radioisotope therapy.

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