Abstract
Radiotherapy (RT) is a key therapeutic strategy for lung cancer, the most common cause of cancer-related deaths worldwide, but radioresistance often occurs and leads to failure of RT. It is therefore important to clarify the mechanism underlying radioresistance in lung cancer. Cancer stem cells (CSCs) are considered the fundamental reason for radioresistance. MicroRNAs (miRNAs) have been regarded as important regulatory molecules of CSCs, carcinogenesis, and treatment response of cancers. It is crucial to clarify how regulation of miRNAs affects repair of DNA damage, redistribution, repopulation, reoxygenation, and radiosensitivity (5R) of lung cancer stem cells (LCSCs). A thorough understanding of the regulation of miRNAs affecting 5R of LCSCs has potential impact on identifying novel targets and thus may improve the efficacy of lung cancer radiotherapy.
Highlights
Lung cancer is the leading cause of cancer-related deaths worldwide, and non-small-cell lung cancer (NSCLC) accounts for approximately 80%–84% of all lung cancers [1]
We draw a diagram on theoretical radiobiology of lung cancer stem cells (LCSCs) and regulatory miRNAs (Figure 1)
After IR, the volume of lung tumor decreases, and LCSCs are enriched in the remaining tumors and their percentage increases
Summary
Lung cancer is the leading cause of cancer-related deaths worldwide, and non-small-cell lung cancer (NSCLC) accounts for approximately 80%–84% of all lung cancers [1]. According to the latest Guidelines of National Comprehensive Cancer Network (NCCN) [2, 3], thoracic radiotherapy (TRT) is an important treatment for early- and advanced-stage NSCLC, as a radical or palliative therapy. Stereotactic body RT (SBRT) allows local tumor control rate to reach 85%–90% in unresectable patients with stage I-II disease [4, 5]. About 60%–70% of all NSCLC patients develop one or more indications for a radical or palliative radiotherapy (RT) during the course of the disease [6]. The local recurrence rate for patients with advanced NSCLC who underwent conventionally fractionated radiotherapy (CFRT) (60 Gy/30 F/6 W) is up to 60%–70% in two years despite application of modern equipment and techniques [7]. The radiobiological mechanism underlying radioresistance needs to be explored to improve the efficacy of RT
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