A Model of Indirect Cell Death Caused by Tumor Vascular Damage after High-Dose Radiotherapy.

Abstract:

:There is increasing evidence that high doses of radiotherapy, like those delivered in stereotactic body radiotherapy (SBRT), trigger indirect mechanisms of cell death. Such effect seems to be two-fold. High doses may trigger an immune response and may cause vascular damage, leading to cell starvation and death. Development of mathematical response models, including indirect death, may help clinicians to design SBRT optimal schedules. Despite increasing experimental literature on indirect tumor cell death caused by vascular damage, efforts on modeling this effect have been limited. In this work, we present a biomathematical model of this effect. In our model, tumor oxygenation is obtained by solving the reaction-diffusion equation; radiotherapy kills tumor cells according to the linear-quadratic model, and also endothelial cells (EC), which can trigger loss of functionality of capillaries. Capillary death will affect tumor oxygenation, driving nearby tumor cells into severe hypoxia. Capillaries can recover functionality due to EC proliferation. Tumor cells entering a predetermined severe hypoxia status die according to a hypoxia-death model. This model fits recently published experimental data showing the effect of vascular damage on surviving fractions. It fits surviving fraction curves and qualitatively reproduces experimental values of percentages of functional capillaries 48 hours postirradiation, and hypoxic cells pre- and 48 hours postirradiation. This model is useful for exploring aspects of tumor and EC response to radiotherapy and constitutes a stepping stone toward modeling indirect tumor cell death caused by vascular damage and accounting for this effect during SBRT planning. SIGNIFICANCE: A novel biomathematical model of indirect tumor cell death caused by vascular radiation damage could potentially help clinicians interpret experimental data and design better radiotherapy schedules.

journal_name

Cancer Res

journal_title

Cancer research

authors

Rodríguez-Barbeito P,Díaz-Botana P,Gago-Arias A,Feijoo M,Neira S,Guiu-Souto J,López-Pouso Ó,Gómez-Caamaño A,Pardo-Montero J

doi

10.1158/0008-5472.CAN-19-0181

subject

Has Abstract

pub_date

2019-12-01 00:00:00

pages

6044-6053

issue

23

eissn

0008-5472

issn

1538-7445

pii

0008-5472.CAN-19-0181

journal_volume

79

pub_type

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