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Abstract
The field of plasma medicine has seen substantial advances over the last decade, with applications developed for bacterial sterilisation, wound healing and cancer treatment. Low temperature plasmas (LTPs) are particularly suited for medical purposes since they are operated in the laboratory at atmospheric pressure and room temperature, providing a rich source of reactive oxygen and nitrogen species (RONS). A great deal of research has been conducted into the role of reactive species in both the growth and treatment of cancer, where long-established radio- and chemo-therapies exploit their ability to induce potent cytopathic effects. In addition to producing a plethora of RONS, LTPs can also create strong electroporative fields. From an application perspective, it has been shown that LTPs can be applied precisely to a small target area. On this basis, LTPs have been proposed as a promising future strategy to accurately and effectively control and eradicate tumours. This review aims to evaluate the current state of the literature in the field of plasma oncology and highlight the potential for the use of LTPs in combination therapy. We also present novel data on the effect of LTPs on cancer stem cells, and speculatively outline how LTPs could circumvent treatment resistance encountered with existing therapeutics.
Highlights
The role of reactive species in cancer initiation, progression and treatment has been intensively researched over the last few decades
Low temperature plasmas’ (LTPs) have demonstrated their potential as a novel approach in the targeted treatment of cancer
This review has highlighted the multifaceted action of LTPs, through the formation of a rich chemistry containing reactive oxygen and nitrogen species (RONS) and the possible contribution of strong electric fields in biological response
Summary
The role of reactive species in cancer initiation, progression and treatment has been intensively researched over the last few decades. Plasmas are ionised gases, comprising a complex environment of charged particles, neutral gas molecules, UV radiation, electric fields and reactive species. The bulk of the plasma consists mainly of background neutral gas atoms and molecules, and due to the inefficient energy transfer between the light electrons and ‘heavy’ neutrals, the global environment remains at room temperature. This aspect allows the application of LTPs to temperature-sensitive materials, such as living tissues
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