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Intraoperative radiotherapy in breast cancer: Alterations to the tumor microenvironment and subsequent biological outcomes (Review)

  • Authors:
    • Yang Yang
    • Xiaochen Hou
    • Shujia Kong
    • Zhuocen Zha
    • Mingqing Huang
    • Chenxi Li
    • Na Li
    • Fei Ge
    • Wenlin Chen

  • View Affiliations

  • Published online on: October 25, 2023     https://doi.org/10.3892/mmr.2023.13118
  • Article Number: 231

  • Copyright: © Yang et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Intraoperative radiotherapy (IORT) is a precise, single high‑dose irradiation directly targeting the tumor bed during surgery. In comparison with traditional external beam RT, it minimizes damage to other normal tissues, ensures an adequate dose to the tumor bed and results in improved cosmetic outcomes and quality of life. Furthermore, IORT offers a shorter treatment duration, lower economic costs and therapeutic efficacy comparable with traditional RT. However, its relatively higher local recurrence rate limits its further clinical applications. Identifying effective radiosensitizing drugs and rational RT protocols will improve its advantages. Furthermore, IORT may not only damage DNA to directly kill breast tumor cells but also alter the tumor microenvironment (TME) to exert a sustained antitumor effect. Specific doses of IORT may exert anti‑angiogenic effects, and consequently antitumor effects, by impacting post‑radiation peripheral blood levels of vascular endothelial growth factor and delta‑like 4. IORT may also modify the postoperative wound fluid composition to continuously inhibit tumor growth, e.g. by reducing components such as microRNA (miR)‑21, miR‑221, miR‑115, oncostatin M, TNF‑β, IL‑6 and IL‑8, and by elevating levels of components such as miR‑223, to inhibit the ability of postoperative wound fluid to induce proliferation, invasion and migration of residual cancer cells. IORT can also modify cancer cell glucose metabolism to inhibit the proliferation of residual tumor cells. In addition, IORT can induce a bystander effect, eliminating the postoperative wound fluid‑induced epithelial‑mesenchymal transition and tumor stem cell phenotype. Insights gained at the molecular level may provide new directions for identifying novel therapeutic targets and approaches. A more comprehensive understanding of the effects of IORT on the breast cancer (BC) TME may further its clinical application. Hence, the present article reviews the primary effects of IORT on BC and its impact on the TME, aiming to offer fresh research perspectives for relevant professionals.
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December-2023
Volume 28 Issue 6

Print ISSN: 1791-2997
Online ISSN:1791-3004

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  • Source Normalized Impact per Paper (SNIP): 0.647
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Spandidos Publications style
Yang Y, Hou X, Kong S, Zha Z, Huang M, Li C, Li N, Ge F and Chen W: Intraoperative radiotherapy in breast cancer: Alterations to the tumor microenvironment and subsequent biological outcomes (Review). Mol Med Rep 28: 231, 2023
APA
Yang, Y., Hou, X., Kong, S., Zha, Z., Huang, M., Li, C. ... Chen, W. (2023). Intraoperative radiotherapy in breast cancer: Alterations to the tumor microenvironment and subsequent biological outcomes (Review). Molecular Medicine Reports, 28, 231. https://doi.org/10.3892/mmr.2023.13118
MLA
Yang, Y., Hou, X., Kong, S., Zha, Z., Huang, M., Li, C., Li, N., Ge, F., Chen, W."Intraoperative radiotherapy in breast cancer: Alterations to the tumor microenvironment and subsequent biological outcomes (Review)". Molecular Medicine Reports 28.6 (2023): 231.
Chicago
Yang, Y., Hou, X., Kong, S., Zha, Z., Huang, M., Li, C., Li, N., Ge, F., Chen, W."Intraoperative radiotherapy in breast cancer: Alterations to the tumor microenvironment and subsequent biological outcomes (Review)". Molecular Medicine Reports 28, no. 6 (2023): 231. https://doi.org/10.3892/mmr.2023.13118