Targeting stem cells by radiation: From the biological angle to clinical aspects.
Radiotherapy is a cornerstone of anticancer treatment. However in spite of technical evolutions, important rates of failure and of toxicity are still reported. Although numerous pre-clinical data have been published, we address the subject of radiotherapy-stem cells interaction from the clinical efficacy and toxicity perspective. On one side, cancer stem cells (CSCs) have been recently evidenced in most of solid tumor primary locations and are thought to drive radio-resistance phenomena. It is particularly suggested in glioblastoma, where CSCs were showed to be housed in the subventricular zone (SVZ). In recent retrospective studies, the radiation dose to SVZ was identified as an independent factor significantly influencing overall survival. On the other side, healthy tissue stem cells radio-destruction has been recently suggested to cause two of the most quality of life-impacting side effects of radiotherapy, namely memory disorders after brain radiotherapy, and xerostomia after head and neck radiotherapy. Recent publications studying the impact of a radiation dose decrease on healthy brain and salivary stem cells niches suggested significantly reduced long term toxicities. Stem cells comprehension should be a high priority for radiation oncologists, as this particular cell population seems able to widely modulate the efficacy/toxicity ratio of radiotherapy in real life patients.
Alexis Vallard, Sophie Espenel, Jean-Baptiste Guy, Yaoxiong Xia, Anis El Meddeb Hamrouni, Majed Ben Mrad, Chloé Rancoule, Nicolas Magné, Department of Radiotherapy, Lucien Neuwirth Cancer Institute, 42271 Saint-Priest en Jarez, France.
Alexis
A
Vallard
Alexis Vallard, Sophie Espenel, Jean-Baptiste Guy, Yaoxiong Xia, Anis El Meddeb Hamrouni, Majed Ben Mrad, Chloé Rancoule, Nicolas Magné, Department of Radiotherapy, Lucien Neuwirth Cancer Institute, 42271 Saint-Priest en Jarez, France.
Sophie
S
Espenel
Alexis Vallard, Sophie Espenel, Jean-Baptiste Guy, Yaoxiong Xia, Anis El Meddeb Hamrouni, Majed Ben Mrad, Chloé Rancoule, Nicolas Magné, Department of Radiotherapy, Lucien Neuwirth Cancer Institute, 42271 Saint-Priest en Jarez, France.
Jean-Baptiste
JB
Guy
Alexis Vallard, Sophie Espenel, Jean-Baptiste Guy, Yaoxiong Xia, Anis El Meddeb Hamrouni, Majed Ben Mrad, Chloé Rancoule, Nicolas Magné, Department of Radiotherapy, Lucien Neuwirth Cancer Institute, 42271 Saint-Priest en Jarez, France.
Peng
P
Diao
Alexis Vallard, Sophie Espenel, Jean-Baptiste Guy, Yaoxiong Xia, Anis El Meddeb Hamrouni, Majed Ben Mrad, Chloé Rancoule, Nicolas Magné, Department of Radiotherapy, Lucien Neuwirth Cancer Institute, 42271 Saint-Priest en Jarez, France.
Yaoxiong
Y
Xia
Alexis Vallard, Sophie Espenel, Jean-Baptiste Guy, Yaoxiong Xia, Anis El Meddeb Hamrouni, Majed Ben Mrad, Chloé Rancoule, Nicolas Magné, Department of Radiotherapy, Lucien Neuwirth Cancer Institute, 42271 Saint-Priest en Jarez, France.
Anis
A
El Meddeb Hamrouni
Alexis Vallard, Sophie Espenel, Jean-Baptiste Guy, Yaoxiong Xia, Anis El Meddeb Hamrouni, Majed Ben Mrad, Chloé Rancoule, Nicolas Magné, Department of Radiotherapy, Lucien Neuwirth Cancer Institute, 42271 Saint-Priest en Jarez, France.
Majed
M
Ben Mrad
Alexis Vallard, Sophie Espenel, Jean-Baptiste Guy, Yaoxiong Xia, Anis El Meddeb Hamrouni, Majed Ben Mrad, Chloé Rancoule, Nicolas Magné, Department of Radiotherapy, Lucien Neuwirth Cancer Institute, 42271 Saint-Priest en Jarez, France.
Alexander Tuan
AT
Falk
Alexis Vallard, Sophie Espenel, Jean-Baptiste Guy, Yaoxiong Xia, Anis El Meddeb Hamrouni, Majed Ben Mrad, Chloé Rancoule, Nicolas Magné, Department of Radiotherapy, Lucien Neuwirth Cancer Institute, 42271 Saint-Priest en Jarez, France.
Claire
C
Rodriguez-Lafrasse
Alexis Vallard, Sophie Espenel, Jean-Baptiste Guy, Yaoxiong Xia, Anis El Meddeb Hamrouni, Majed Ben Mrad, Chloé Rancoule, Nicolas Magné, Department of Radiotherapy, Lucien Neuwirth Cancer Institute, 42271 Saint-Priest en Jarez, France.
Chloé
C
Rancoule
Alexis Vallard, Sophie Espenel, Jean-Baptiste Guy, Yaoxiong Xia, Anis El Meddeb Hamrouni, Majed Ben Mrad, Chloé Rancoule, Nicolas Magné, Department of Radiotherapy, Lucien Neuwirth Cancer Institute, 42271 Saint-Priest en Jarez, France.
Nicolas
N
Magné
Cancer; Efficacy; Neoplastic stem cells; Radiation therapy; Toxicity