The influence of tumor blood flow and microenvironmental factors on the efficacy of radiation, drugs and localized hyperthermia

It is generally accepted that tumor blood flow, microcirculation, oxygen and nutrient supply, tissue pH distribution, and the bioenergetic status-factors which are usually closely linked and which define the so-called metabolic microenvironment--can markedly influence the therapeutic response of mal...

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Bibliographic Details
Published in:	Klinische Pädiatrie Vol. 209; no. 4; p. 243
Main Author:	Vaupel, P W
Format:	Journal Article
Language:	English
Published:	Germany 01-07-1997
Subjects:	Animals Cell Division - drug effects Cell Division - physiology Cell Division - radiation effects Cell Hypoxia - drug effects Cell Hypoxia - physiology Cell Hypoxia - radiation effects Cell Survival - drug effects Cell Survival - physiology Cell Survival - radiation effects Chemotherapy, Adjuvant Child Combined Modality Therapy Energy Metabolism - drug effects Energy Metabolism - physiology Energy Metabolism - radiation effects Humans Hyperthermia, Induced Immunotherapy Neoplasms - blood supply Neoplasms - therapy Prognosis Radiotherapy, Adjuvant Regional Blood Flow - drug effects Regional Blood Flow - physiology Regional Blood Flow - radiation effects
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Summary:	It is generally accepted that tumor blood flow, microcirculation, oxygen and nutrient supply, tissue pH distribution, and the bioenergetic status-factors which are usually closely linked and which define the so-called metabolic microenvironment--can markedly influence the therapeutic response of malignant tumors to conventional irradiation, chemotherapy, other nonsurgical treatment modalities, and the cell proliferation activity within tumors. Currently available information on the parameters defining the metabolic micromilieu in human tumors is presented in this review. According to these data, significant variations in these relevant factors are likely to occur between different locations within a tumor, and between tumors of the same grade and clinical stage. The extent and mechanisms by which the microenvironmental factors influence cellular response to standard irradiation, chemotherapeutic drugs, immunotherapy and localized hyperthermia are described and "physiological" barriers to treatment are outlined.
ISSN:	0300-8630
DOI:	10.1055/s-2008-1043957