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REVIEW article

Front. Oncol.
Sec. Radiation Oncology
Volume 14 - 2024 | doi: 10.3389/fonc.2024.1477448

Radioresistance and Brain Metastases: A Review of the Literature and Applied Perspective

Provisionally accepted
Andrew Youssef Andrew Youssef 1*Arjun Sahgal Arjun Sahgal 2Sunit Das Sunit Das 3*
  • 1 University of Toronto, Toronto, Canada
  • 2 Sunnybrook Health Science Centre, University of Toronto, Toronto, Ontario, Canada
  • 3 Division of Neurosurgery, St. Michael's Hospital, Toronto, Ontario, Canada

The final, formatted version of the article will be published soon.

    Intracranial metastatic disease is a serious complication of cancer, treated through surgery, radiation, and targeted therapies. The central role of radiation therapy makes understanding the radioresistance of metastases a priori a key interest for prognostication and therapeutic development. Although historically defined clinic-radiographically according to tumour response, developments in new techniques for delivering radiation treatment and understanding of radioprotective mechanisms led to a need to revisit the definition of radioresistance in the modern era. Factors influencing radioresistance include tumour-related factors (hypoxia, cancer stem cells, tumour kinetics, tumour microenvironment, metabolic alterations, tumour heterogeneity DNA damage repair, non-coding RNA, exosomes, methylomes, and autophagy), host-related factors (volume effect & dose-limiting non-cancerous tissue, pathophysiology, and exosomes), technical factors, and probabilistic factors (cell cycle and random gravity of DNA damage). Influences on radioresistance are introduced and discussed in the context of brain metastases.

    Keywords: Radiotherapy, Cancer, Brain, metastases, radioresistance

    Received: 08 Aug 2024; Accepted: 09 Oct 2024.

    Copyright: © 2024 Youssef, Sahgal and Das. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Andrew Youssef, University of Toronto, Toronto, Canada
    Sunit Das, Division of Neurosurgery, St. Michael's Hospital, Toronto, M5B 1W8, Ontario, Canada

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.