Acute Versus Chronic Hypoxia: Why a Simplified Classification is Simply Not Enough

Bayer, Christine; Shi, Kuangyu; Astner, Sabrina T.; Maftei, Constantin-Alin; Vaupel, Peter

doi:10.1016/j.ijrobp.2011.02.049

Cited by 101 publications

(92 citation statements)

References 11 publications

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“…The hypoxic area in a tumor has been reported to include chronic hypoxia and acute hypoxia (1,21). Acute hypoxia can change every few hours or days.…”

Section: Discussionmentioning

confidence: 99%

High Reproducibility of Tumor Hypoxia Evaluated by ¹⁸F-Fluoromisonidazole PET for Head and Neck Cancer

et al. 2013

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“…The hypoxic area in a tumor has been reported to include chronic hypoxia and acute hypoxia (1,21). Acute hypoxia can change every few hours or days.…”

Section: Discussionmentioning

confidence: 99%

High Reproducibility of Tumor Hypoxia Evaluated by ¹⁸F-Fluoromisonidazole PET for Head and Neck Cancer

et al. 2013

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“…In addition, non-functional lymphatics and high interstitial fluid pressure generated by proliferating tumor cells compresses lymphatics, and blood vessels are also present in the tumor microenvironment. Therefore, an additional source of chronic hypoxia may be caused by a compromised perfusion of leaky microvessels (11,109).…”

Section: Chronic Hypoxiamentioning

confidence: 99%

Imaging Tumor Hypoxia to Advance Radiation Oncology

Lee

Boss

Dewhirst

2014

Antioxidants & Redox Signaling

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Significance: Most solid tumors contain regions of low oxygenation or hypoxia. Tumor hypoxia has been associated with a poor clinical outcome and plays a critical role in tumor radioresistance. Recent Advances: Two main types of hypoxia exist in the tumor microenvironment: chronic and cycling hypoxia. Chronic hypoxia results from the limited diffusion distance of oxygen, and cycling hypoxia primarily results from the variation in microvessel red blood cell flux and temporary disturbances in perfusion. Chronic hypoxia may cause either tumor progression or regressive effects depending on the tumor model. However, there is a general trend toward the development of a more aggressive phenotype after cycling hypoxia. With advanced hypoxia imaging techniques, spatiotemporal characteristics of tumor hypoxia and the changes to the tumor microenvironment can be analyzed. Critical Issues: In this review, we focus on the biological and clinical consequences of chronic and cycling hypoxia on radiation treatment. We also discuss the advanced non-invasive imaging techniques that have been developed to detect and monitor tumor hypoxia in preclinical and clinical studies. Future Directions: A better understanding of the mechanisms of tumor hypoxia with non-invasive imaging will provide a basis for improved radiation therapeutic practices. Antioxid. Redox Signal. 21, 313-337.

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“…In each of these hypoxia subtypes, oxygen supply is critically reduced, but perfusiondependent delivery of diagnostic and therapeutic agents, supply of nutrients and removal of waste products, and repair competence can vary or may be unaffected [10]. Thus, detailed differentiation of tumor hypoxia may impact on our understanding of tumor biology and may aid in the development of novel treatment strategies (e.g., modulation of fractionation schedules), in tumor detection by imaging and tumor targeting, and is thus of upmost clinical importance far beyond an academic discussion.…”

Section: Introductionmentioning

confidence: 99%

Hypoxia in Tumors: Pathogenesis-Related Classification, Characterization of Hypoxia Subtypes, and Associated Biological and Clinical Implications

Vaupel

Mayer

2014

Advances in Experimental Medicine and Biology

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Hypoxia is a hallmark of tumors leading to (mal-)adaptive processes, development of aggressive phenotypes and treatment resistance. Based on underlying mechanisms and their duration, two main types of hypoxia have been identified, coexisting with complex spatial and temporal heterogeneities. Chronic hypoxia is mainly caused by diffusion limitations due to enlarged diffusion distances and adverse diffusion geometries (e.g., concurrent vs. countercurrent microvessels, Krogh- vs. Hill-type diffusion geometry) and, to a lesser extent, by hypoxemia (e.g., in anemic patients, HbCO formation in heavy smokers), and a compromised perfusion or flow stop (e.g., due to disturbed Starling forces or intratumor solid stress). Acute hypoxia mainly results from transient disruptions in perfusion (e.g., vascular occlusion by cell aggregates), fluctuating red blood cell fluxes or short-term contractions of the interstitial matrix. In each of these hypoxia subtypes oxygen supply is critically reduced, but perfusion-dependent nutrient supply, waste removal, delivery of anticancer or diagnostic agents, and repair competence can be impaired or may not be affected. This detailed differentiation of tumor hypoxia may impact on our understanding of tumor biology and may aid in the development of novel treatment strategies, tumor detection by imaging and tumor targeting, and is thus of great clinical relevance.

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Acute Versus Chronic Hypoxia: Why a Simplified Classification is Simply Not Enough

Cited by 101 publications

References 11 publications

High Reproducibility of Tumor Hypoxia Evaluated by ¹⁸F-Fluoromisonidazole PET for Head and Neck Cancer

High Reproducibility of Tumor Hypoxia Evaluated by ¹⁸F-Fluoromisonidazole PET for Head and Neck Cancer

Imaging Tumor Hypoxia to Advance Radiation Oncology

Hypoxia in Tumors: Pathogenesis-Related Classification, Characterization of Hypoxia Subtypes, and Associated Biological and Clinical Implications

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Acute Versus Chronic Hypoxia: Why a Simplified Classification is Simply Not Enough

Cited by 101 publications

References 11 publications

High Reproducibility of Tumor Hypoxia Evaluated by 18F-Fluoromisonidazole PET for Head and Neck Cancer

High Reproducibility of Tumor Hypoxia Evaluated by 18F-Fluoromisonidazole PET for Head and Neck Cancer

Imaging Tumor Hypoxia to Advance Radiation Oncology

Hypoxia in Tumors: Pathogenesis-Related Classification, Characterization of Hypoxia Subtypes, and Associated Biological and Clinical Implications

Contact Info

Product

Resources

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High Reproducibility of Tumor Hypoxia Evaluated by ¹⁸F-Fluoromisonidazole PET for Head and Neck Cancer

High Reproducibility of Tumor Hypoxia Evaluated by ¹⁸F-Fluoromisonidazole PET for Head and Neck Cancer