Abstract
In the past 20 years, the classic paradigm in radiobiology recognizing DNA as the main target for the action of radiation has changed. The new paradigm assumes that both targeted and non-targeted effects of radiation determine the final outcome of irradiation. Radiotherapy is one of the main modality treatments of neoplastic diseases with intent to cure, or sometimes to palliate only, thus radiation-induced non-targeted effect, commonly referred to as the radiation-induced bystander effect (RIBE) may have a share in cancer treatment. RIBE is mediated by molecular signaling from radiation targeted cells to their non-irradiated neighbors, and comprises such phenomena as bystander effect, genomic instability, adaptive response and abscopal effect. Whereas first three phenomena may appear both in vitro and in vivo, an abscopal effect is closely related to partial body irradiation and is a systemic effect mediated by immunologic system which synergizes with radiotherapy. From the clinical point of view abscopal effect is particularly interesting due to both its possible valuable contribution to the treatment of metastases, and the potential harmful effects as induction of genetic instability and carcinogenesis. This review summarized the main results of investigations of non-targeted effects coming from in vitro monolayer cultures, 3-dimentional models of tissues, preclinical studies on rodents and clinically observed beneficial abscopal effects with particular emphasis on participation of immunotherapy in the creation of abscopal effects.
Highlights
Radiation-induced bystander effect (RIBE) is a non-targeted effect commonly defined as the induction of bio-How to cite this paper: Widel, M. (2016) Radiation Induced Bystander Effect: From in Vitro Studies to Clinical Application
The useful influence will appear if irradiated tumor cells damage neighboring tumor cells in the margin or within irradiated volume or if an abscopal effect inhibits the growth of metastases
There is a great lack of knowledge concerning the existence and role of the bystander effect in fractionated radiotherapy, intensity-modulated radiation therapy (IMRT) as well as conventional radiotherapy, which is still an important element in cancer treatment
Summary
Radiation-induced bystander effect (RIBE) is a non-targeted effect commonly defined as the induction of bio-. The bystander effect may be a potentially harmful (damaging of neighboring normal cells in vivo), or even useful event in radiotherapy (the elevation of damage to tumor cells not directly hit by radiation), both leading to modulation of the therapeutic ratio. The answers to these questions can be drown from in vitro experiments and preclinical data which carry some clinically useful information regarding the radiation induced non-targeted effects and their possible implications for cancer treatment. Preclinical investigations and clinical reports indicate that abscopal effects are immune mediated and are mainly induced in concomitant treatment by immunotherapy and radiotherapy, which operate synergistically. This immunologic aspect, and on the other hand, a possible role of abscopal effect in carcinogenesis via induction of genetic instability is pointed out
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