Particle Therapy 2017

Reoxygenation

(treatment-induced)

dying tumor cell

tumor cell

stress granule

reoxygenation injury

Increases growth factor levels, promoting endothelial cell survival, angiogenesis and tumor cell survival and proliferation More tumor cells with higher oxygenation status, yielding a better tumor cell kill during the next radiation fractions

released HIF1α

ROS

immune cells

stabilization of HIF1α

NO

Modified from Dewhirst et al., Nature Reviews Cancer 2008