Combined radiation strategies for novel and enhanced cancer treatment

Abstract

Numerous studies focus on cancer therapy worldwide, and although many advances have been recorded, the complexity of the disease dictates thinking out of the box to confront it. This study reviews some of the currently available ionizing (IR) and non-ionizing radiation (NIR)-based treatment methods and explores their possible combinations that lead to synergistic, multimodal approaches with promising therapeutic outcomes. Traditional techniques, like radiotherapy (RT) show decent results, although they cannot spare 100% the healthy tissues neighboring with the cancer ones. Targeted therapies, such as proton and photodynamic therapy (PT and PDT, respectively) present adequate outcomes, even though each one has its own drawbacks. To overcome these limitations, the combination of therapeutic modalities has been proposed and has already been showing promising results. At the same time, the recent advances in nanotechnology in the form of nanoparticles enhance cancer therapy, making multimodal treatments worthy of exploring and studying. The combination of RT and PDT has reached the level of clinical trials and is showing promising results. Moreover, in vitro and in vivo studies of nanoparticles with PDT have also provided beneficial results concerning enhanced radiation treatments. In any case, novel and multimodal approaches have to be adopted to achieve personalized, enhanced and effective cancer treatment.

Keywords:

• Multimodal treatment
• photodynamic therapy
• RT–PDT combination
• NPs–PDT combination
• proton–PDT combination

Disclosure statement

The authors report no conflict of interest. The funding sources had no involvement in the study design; in the collection, analysis and interpretation of data; in the writing of the report; and in the decision to submit the article for publication.

Additional information

Funding

The authors G. K. and I. T. state that their part of this research has been co-financed by Greece and the European Union (European Social Fund – ESF) through the Operational Program ‘Human Resources Development, Education and Lifelong Learning’ in the context of the project ‘Strengthening Human Resources Research Potential via Doctorate Research’ [MIS-5000432], implemented by the State Scholarships Foundation (ΙΚΥ) [Scholarships numbers: 2018-050-0502-14578 and 2018-050-0502-15801, respectively]. The authors E. D., A. A. S. and M. M. participate in a European synergy project, namely the ‘ELI - LASERLAB Europe, HiPER & IPERION-CH.gr’ [MIS-5002735].

Notes on contributors

Georgios Kareliotis

Georgios Kareliotis, MSc, is a certified Medical Physicist and a Medical Laser Safety Officer (MLSO). He was graduated from the School of Applied Mathematical and Physical Sciences of the National Technical University of Athens (NTUA), Greece. He completed his Master of Science in Medical Physics and Radiation Physics at the National and Kapodistrian University of Athens (NKUA), Greece. He is currently working on his PhD in Medical Physics and Biophotonics at the NTUA’s Physics Department. His research interests include Photodynamic Therapy dosimetry, laser-tissue interactions, photothermal effects of nanoparticles in tissues, Radiation Protection and laser modification of intraocular lenses.

Ioanna Tremi

Ioanna Tremi, MSc, is a PhD student at the School of Applied Mathematical and Physical Sciences of NTUA. She holds a BSc in Mathematics and an MSc in Nanosystems and Nanodevices. She is an experienced researcher in Radiation and Cancer Biology, Transmission Electron Microscopy (TEM) as well as in bio-Nanotechnology. She has also worked in the field of Computational Biology/Chemistry by performing Molecular Dynamics (MD) simulations in biological membranes, with published results. Currently, she is working on DNA damage detection and biological responses after irradiation and under the presence of gold nanoparticles.

Myrsini Kaitatzi

Myrsini Kaitatzi is an undergraduate student at the School of Applied Mathematical and Physical Sciences of NTUA. She has worked for 14 months as Technical student at the European Organization for Nuclear Research (CERN) to investigate beam dynamics in the CERN Proton Synchrotron. She has experience in real time measurements, Python data analysis, and use of laser sources. Concerning her research interests, one could include Laser Physics, Nuclear Physics, and Optics.

Eleni Drakaki

Eleni Drakaki is a physics research fellow at NTUA. She holds a BSc in Physics, an MSc in Physical Sciences and Technologies, and a PhD in interaction of laser radiation with biological tissues and metallic objects. She has been employed as teaching assistant or research fellow at several institutions including National Technical University of Athens, National and Kapodistrian University of Athens, Hellenic Open University, University of West Attica, University of Applied Sciences of Central Greece, Technological Educational Institute of Western Greece, and National Hellenic Research Foundation. She has been involved in R&D projects funded from organizations such as the European Union, the Ministry of Development and the Ministry of Education. Drakaki has written more than 50 research papers for scientific journals and conference proceedings.

Alexandros A. Serafetinides

Alexandros A. Serafetinides is an Emeritus Professor in the Physics Department of NTUA’s School of Applied Mathematical and Physical Sciences. He received his BSc in Physics from the NKUA in 1973, his MSc and PhD in Optoelectronics and Lasers from the Physics Department of the University of Essex, UK, in 1974 and 1978, respectively. He has attended more than 20 short-duration training courses on lasers, electro-optics and laser applications between 1975 and 2020 and has more than 47 years of experience in laser development, laser applications and optoelectronics. His specific interests include pulsed atomic and molecular gas lasers, solid state lasers, detection systems, semiconductor studies, waveguides and fibers, lasers applications in biophysics and medicine, range-finding and pollution monitoring, industrial applications of lasers, radiation pressure effects, optical trapping, laser treatment, and evaluation of cultural heritage objects. He has published more than 90 scientific papers in international refereed journals, more than 220 articles in international conference proceedings and 10 books in Greek. He is the Editor of 12 International Conference Proceedings. In 2007, he received the badge of honor ‘For special merit to the Bulgarian Academy of Sciences’. Prof. Serafetinides served as the President/Dean of the School of Applied Mathematical and Physical Sciences at NTUA and a Member of the NTUA’s Senate from September 2010 to April 2013.

Mersini Makropoulou

Mersini Makropoulou is a Professor in the Physics Department of NTUA’s School of Applied Mathematical and Physical Sciences. She received her BSc in Physics from the NKUA in 1976 and her PhD in Biophysics from the University of Bucharest in Romania in 1982. Prof. Makropoulou joined the NTUA’s Physics Department in 1990 and has more than 30 years’ experience in laser–tissues and –biomaterials interactions for medical and biophysical applications. Her specialization field is Radiation Biophysics and Biophotonics (Biomedical Applications of Laser Radiation). She has supervised more than 35 BSc, MSc, and PhD theses and has written over 115 articles in international journals and conference proceedings.

Alexandros G. Georgakilas

Alexandros G. Georgakilas is an Associate Professor in the Physics Department of NTUA’s School of Applied Mathematical and Physical Sciences. He completed his post-doc research in the Biology Department at Brookhaven National Laboratory, USA, and developed his own research laboratory as an Associate Professor at the Biology Department of East Carolina University until 2012. He has received many awards, such as the Young Investigator Travel Award from Radiation Research Society, Radiation Research Society SIT Award, ECU Thomas Harriot College Research Award and the prestigious Terashima Award from Japan Radiation Research Society. His work at ECU as Principal Investigator has been funded by various sources. He has more than 110 publications in peer-reviewed, high-profile journals, with more than half of them been written since he joined NTUA, which have already received more than 8000 citations (h index = 45). He has also been appointed Editor-in-Chief in the Journal of Biochemical Technology 2012–2015, Associate Editor Position for Cancer Letters, Radiation Research and in several other well-recognized journals. Prof. Georgakilas has been invited as a Guest Editor for a many high-impact journals and has hold invited Editorial positions for various book projects. His research interests include Radiation Biology, DNA Damage and Repair, Biomarker discovery for efficient radiation therapy and Bioinformatics.