Patrick G Johnston Centre for Cancer Research, Queen's University Belfast, 97 Lisburn Road, Belfast BT9 7AE, United Kingdom.
Ulster University School of Engineering, York Street, Belfast BT15 1AP, United Kingdom.
Phys Med Biol. 2024 Sep 2;69(18). doi: 10.1088/1361-6560/ad70f0.
Radiotherapy has played an essential role in cancer treatment for over a century, and remains one of the best-studied methods of cancer treatment. Because of its close links with the physical sciences, it has been the subject of extensive quantitative mathematical modelling, but a complete understanding of the mechanisms of radiotherapy has remained elusive. In part this is because of the complexity and range of scales involved in radiotherapy-from physical radiation interactions occurring over nanometres to evolution of patient responses over months and years. This review presents the current status and ongoing research in modelling radiotherapy responses across these scales, including basic physical mechanisms of DNA damage, the immediate biological responses this triggers, and genetic- and patient-level determinants of response. Finally, some of the major challenges in this field and potential avenues for future improvements are also discussed.
放疗在癌症治疗中已经发挥了一个多世纪的重要作用,并且仍然是研究最多的癌症治疗方法之一。由于它与物理科学密切相关,因此已经成为广泛的定量数学建模的主题,但对放疗机制的完全理解仍然难以捉摸。部分原因是放疗涉及的复杂性和范围,从发生在纳米级的物理辐射相互作用到数月和数年的患者反应演变。这篇综述介绍了在这些尺度上模拟放疗反应的当前现状和正在进行的研究,包括 DNA 损伤的基本物理机制、这引发的即时生物学反应,以及反应的遗传和患者水平决定因素。最后,还讨论了该领域的一些主要挑战和未来改进的潜在途径。