Main Approaches to Enhance Radiosensitization in Cancer Cells by Nanoparticles: A Systematic Review

Behnaz Babaye Abdollahi,Fatemeh Salehnia,Reza Malekzadeh,Marjan Ghorbani,Fatemeh Pournaghi Azar,Ali Reza Farajollahi,Hamed Hamishehkar,Ali Reza Naseri

doi:10.34172/apb.2021.025

Behnaz Babaye Abdollahi, Fatemeh Salehnia + Show 6 more

Open Access

https://doi.org/10.34172/apb.2021.025

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Abstract

In recent years, high atomic number nanoparticles (NPs) have emerged as promising radio-enhancer agents for cancer radiation therapy due to their unique properties. Multi-disciplinary studies have demonstrated the potential of NPs-based radio-sensitizers to improve cancer therapy and tumor control at cellular and molecular levels. However, studies have shown that the dose enhancement effect of the NPs depends on the beam energy, NPs type, NPs size, NPs concentration, cell lines, and NPs delivery system. It has been believed that radiation dose enhancement of NPs is due to the three main mechanisms, but the results of some simulation studies failed to comply well with the experimental findings. Thus, this study aimed to quantitatively evaluate the physical, chemical, and biological factors of the NPs. An organized search of PubMed/Medline, Embase, ProQuest, Scopus, Cochrane and Google Scholar was performed. In total, 77 articles were thoroughly reviewed and analyzed. The studies investigated 44 different cell lines through 70 in-vitro and 4 in-vivo studies. A total of 32 different types of single or core-shell NPs in different sizes and concentrations have been used in the studies.

Highlights

Cancer is the leading cause of mortality across most developed countries and the second main reason of death in developing countries, with more than 8.2 million deaths every year.[1,2,3] Surgery, chemotherapy, and radiation therapy (RT) are three major modalities for cancer treatment.[4]
Research results and study selection Totally, 1670 relevant articles were identified through the literature search; of these 77 studies met the inclusions criteria which examined the effectiveness of NPs during RT and thence considered as relevant and included in the systematic review
Common types were gold (Au, with atomic number 79) in 56 studies, gadolinium (Gd, with atomic number 64) in seven studies, core-shell NPs, in six studies, bismuth (Ba, with atomic number 83) in 4 studies, platinum (Pt, with atomic number 78), silver (Ag, with atomic number 47), and iron (Fe, with atomic number 26), with each used in three studies, titanium (Ti, with atomic number 22) in two studies; other NP types included hafnium (Hf, with atomic number 72), silicon (Si, with atomic number), zinc (Zn, with atomic number 30), neodymium (Nd, with atomic number 60), lanthanide (La, with atomic number 57), cerium (Ce, with atomic number 58), tantalum (Ta, with atomic number 73), which each used in one study (Figure 2)

Summary

Introduction

Cancer is the leading cause of mortality across most developed countries and the second main reason of death in developing countries, with more than 8.2 million deaths every year.[1,2,3] Surgery, chemotherapy, and radiation therapy (RT) are three major modalities for cancer treatment.[4] In particular, RT is one of the successful cancer treatment strategies used for more than 60% of all cancer patients.[5,6] It causes tumor cell death by delivery of high intensity ionizing radiations to the tumor tissue.[7]. The sensitivity of the highly or functionally active tumor cells is somewhat higher than that of nearby or adjacent normal tissue. Attempts are being made to improve the efficiency of RT mainly by: (I) enhancing the radiation dose inside the cancer cells;

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