Impact of radiotherapy on microsurgical reconstruction of the head and neck

Hohlweg-Majert, Bettina; Ristow, Oliver; Gust, Katharina; Kehl, Victoria; Wolff, Klaus‐Dietrich; Pigorsch, Steffi

doi:10.1007/s00432-012-1263-6

Cited by 26 publications

(15 citation statements)

References 32 publications

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“…By applying DCE-MRI as a non-invasive method to monitor the tumor vascular function we found that RTx FR enhanced tumor perfusion. This is in line with observations in patients [25-27, 35-37] and in different preclinical tumor models [30, 31, 38]. In the current study, we measured perfusion during the course of RTx FR revealing that the induction of tumor perfusion became apparent after 2 weeks of treatment.…”

Section: Discussionsupporting

confidence: 90%

Low dose angiostatic treatment counteracts radiotherapy-induced tumor perfusion and enhances the anti-tumor effect

et al. 2016

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The extent of tumor oxygenation is an important factor contributing to the efficacy of radiation therapy (RTx). Interestingly, several preclinical studies have shown benefit of combining RTx with drugs that inhibit tumor blood vessel growth, i.e. angiostatic therapy. Recent findings show that proper scheduling of both treatment modalities allows dose reduction of angiostatic drugs without affecting therapeutic efficacy. We found that whilst low dose sunitinib (20 mg/kg/day) did not affect the growth of xenograft HT29 colon carcinoma tumors in nude mice, the combination with either single dose RTx (1x 5Gy) or fractionated RTx (5x 2Gy/week, up to 3 weeks) substantially hampered tumor growth compared to either RTx treatment alone. To better understand the interaction between RTx and low dose angiostatic therapy, we explored the effects of RTx on tumor angiogenesis and tissue perfusion. DCE-MRI analyses revealed that fractionated RTx resulted in enhanced perfusion after two weeks of treatment. This mainly occurred in the center of the tumor and was accompanied by increased tissue viability and decreased hypoxia. These effects were accompanied by increased expression of the pro-angiogenic growth factors VEGF and PlGF. DCE-MRI and contrast enhanced ultrasonography showed that the increase in perfusion and tissue viability was counteracted by low-dose sunitinib. Overall, these data give insight in the dynamics of tumor perfusion during conventional 2 Gy fractionated RTx and provide a rationale to combine low dose angiostatic drugs with RTx both in the palliative as well as in the curative setting.

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Section: Discussionsupporting

confidence: 90%

Low dose angiostatic treatment counteracts radiotherapy-induced tumor perfusion and enhances the anti-tumor effect

et al. 2016

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“…Whenever there is insufficient adjacent tissue, defect coverage heavily relies on free vascularized tissue transfer (Choi et al, 2004;Shah and Gil, 2009;Hohlweg-Majert et al, 2012). A leading option for extensive facial defects has to be seen in latissimus dorsi myocutaneous flap reconstruction (Choi et al, 2004;Horn et al, 2014).…”

Section: Introductionmentioning

confidence: 99%

“…In addition, therapy of head and neck cancer frequently mandates the use of adjuvant irradiation; however, this use of radiotherapy can result in a loss of flexibility for connective tissues and the vascular system (Hohlweg-Majert et al, 2012). Furthermore, adjuvant radiotherapy is associated with deleterious effects on free flaps, such as fat necrosis and volume loss (Buchholz et al, 2002;Haykal et al, 2013).…”

Section: Introductionmentioning

confidence: 99%

Microvascular transplants in head and neck reconstruction: 3D evaluation of volume loss

Bittermann

Thönissen

Poxleitner

et al. 2015

Journal of Cranio-Maxillofacial Surgery

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“…After complete tumour resection of advanced oral squamous cell carcinoma (SCC), defect coverage relies heavily on microsurgical free flap techniques (Hohlweg-Majert et al, 2012). Furthermore, therapy of SCC frequently mandates the use of adjuvant irradiation.…”

Section: Introductionmentioning

confidence: 99%

The validity of surgical clips as radiographic markers for the tumour resection cavity in head and neck cancer treatment

Bittermann

Voss

Duttenhoefer

et al. 2015

Journal of Cranio-Maxillofacial Surgery

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Impact of radiotherapy on microsurgical reconstruction of the head and neck

Cited by 26 publications

References 32 publications

Low dose angiostatic treatment counteracts radiotherapy-induced tumor perfusion and enhances the anti-tumor effect

Low dose angiostatic treatment counteracts radiotherapy-induced tumor perfusion and enhances the anti-tumor effect

Microvascular transplants in head and neck reconstruction: 3D evaluation of volume loss

The validity of surgical clips as radiographic markers for the tumour resection cavity in head and neck cancer treatment

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