Radioresistant tumours: From identification to targeting.

Area of Science:

• Oncology
• Radiation Oncology
• Medical Imaging

Background:

• Tumour radioresistance is a complex challenge in radiation oncology, influenced by various biological factors.
• Mechanisms include oncogenic signaling, metabolism, proliferation, tumor microenvironment (hypoxia), and genomics.
• Understanding these factors is crucial for improving radiotherapy outcomes.

Purpose of the Study:

• To review the multifaceted mechanisms of tumour radioresistance.
• To explore theragnostic approaches linking tumour biology and imaging.
• To discuss advanced radiotherapy strategies for overcoming radioresistance.

Main Methods:

• Literature review of tumour radioresistance mechanisms.
• Discussion of theragnostic applications using biological imaging and biomarkers.
• Analysis of dose prescription modeling and advanced particle therapy techniques.

Main Results:

• Identified key mechanisms of radioresistance: oncogenic pathways, metabolism, hypoxia, and genomics.
• Highlighted the potential of theragnostic approaches correlating tumour histology with imaging.
• Investigated dose painting strategies and limitations of low lineal energy transfer particles.

Conclusions:

• Overcoming tumour radioresistance requires a comprehensive understanding of its underlying biological mechanisms.
• Theranostic imaging and advanced radiotherapy techniques, such as high lineal energy transfer particles or nanoparticles, offer promising avenues for enhancing tumour curability.