Therapeutic benefit from combined heat and radiation

Spontaneous metastasis, proliferation characteristics and radiation sensitivity of fractionated irradiation recurrent and unirradiated human xenografts

PURPOSE

Do tumor cells which survive high dose fractionated irradiation exhibit modified metastasis activity, proliferation kinetics, and/or radiation sensitivity? To address this question experimentally, we have studied three recurrent human tumor xenograft systems.

METHODS AND MATERIALS

Three models were derived from a soft tissue sarcoma (HSTS26T), a colon adenocarcinoma (HCT15), and a glioblastoma (HGL21) which had recurred after 90 Gy, 109 Gy, or 77.4 Gy administered in 30 equal doses, respectively. Their production of spontaneous metastasis and cell proliferation characteristics were studied in early generation xenografts in SCID mice, and were compared to those in their previously unirradiated counterparts. As a control, we have also studied each tumor as a post-surgical recurrence. Specimens from the irradiated recurrent and their unirradiated primary tumors were cultured in vitro and their radiation sensitivity determined by clonogenic assay.

RESULTS

The three irradiated recurrent tumor systems retained the individual histological features of their unirradiated primary xenografts. A lower metastatic incidence was observed in two of the three irradiated recurrent tumor lines in comparison with their unirradiated control tumors and their surgical recurrent counterparts. No significant differences were found between the irradiated recurrent tumors and their unirradiated counterparts with respect to: volume doubling time, growth time, potential doubling time, mitotic index, PCNA index, and SF2 values.

CONCLUSIONS

High dose irradiation given in 30 fractions did not increase the metastatic activity in the three human tumor xenograft systems. Furthermore, the fractionated irradiation did not significantly change their proliferation characteristics and cellular radiation sensitivity.

Radiation enhancement of metastasis: a review

Virtually every modality employed in the treatment of cancer has demonstrated an adverse effect upon metastasis under some conditions. This review surveys the experimental and clinical literature pertaining to the untoward effects of ionizing radiation upon metastatic processes. Two processes are described: (1) enhancement of metastases following local tumor irradiation; (2) localization of metastasis in previously irradiated normal tissues. In the first process the experimental evidence indicates a local effect of irradiation upon the tumor-stroma interface. It predominates under conditions of non-curative radiation doses. There is no proof that this process occurs in clinical practice, but a review of data provides suggestive evidence for its existence following non-curative therapy. The second process is documented both experimentally and clinically. It requires the presence of viable, circulating tumor cells and appears mediated through vascular damage. The few clinical reports suggest that this effect is rare in practice. The clinical significance of both processes appears small under conditions of effective tumor therapy, but it is speculated that inadequate tumor irradiation, or irradiation of normal tissues with uncontrolled tumor elsewhere, may be deleterious.