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      Cancer and Radiation Therapy: Current Advances and Future Directions

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          Abstract

          In recent years remarkable progress has been made towards the understanding of proposed hallmarks of cancer development and treatment. However with its increasing incidence, the clinical management of cancer continues to be a challenge for the 21 st century. Treatment modalities comprise of radiation therapy, surgery, chemotherapy, immunotherapy and hormonal therapy. Radiation therapy remains an important component of cancer treatment with approximately 50% of all cancer patients receiving radiation therapy during their course of illness; it contributes towards 40% of curative treatment for cancer. The main goal of radiation therapy is to deprive cancer cells of their multiplication (cell division) potential. Celebrating a century of advances since Marie Curie won her second Nobel Prize for her research into radium, 2011 has been designated the Year of Radiation therapy in the UK. Over the last 100 years, ongoing advances in the techniques of radiation treatment and progress made in understanding the biology of cancer cell responses to radiation will endeavor to increase the survival and reduce treatment side effects for cancer patients. In this review, principles, application and advances in radiation therapy with their biological end points are discussed.

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          Most cited references45

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          Global cancer statistics

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            The role of autophagy in cancer development and response to therapy.

            Autophagy is a process in which subcellular membranes undergo dynamic morphological changes that lead to the degradation of cellular proteins and cytoplasmic organelles. This process is an important cellular response to stress or starvation. Many studies have shed light on the importance of autophagy in cancer, but it is still unclear whether autophagy suppresses tumorigenesis or provides cancer cells with a rescue mechanism under unfavourable conditions. What is the present state of our knowledge about the role of autophagy in cancer development, and in response to therapy? And how can the autophagic process be manipulated to improve anticancer therapeutics?
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              Death through a tragedy: mitotic catastrophe.

              Mitotic catastrophe (MC) has long been considered as a mode of cell death that results from premature or inappropriate entry of cells into mitosis and can be caused by chemical or physical stresses. Whereas it initially was depicted as the main form of cell death induced by ionizing radiation, it is today known to be triggered also by treatment with agents influencing the stability of microtubule, various anticancer drugs and mitotic failure caused by defective cell cycle checkpoints. Although various descriptions explaining MC exist, there is still no general accepted definition of this phenomenon. Here, we present evidences indicating that death-associated MC is not a separate mode of cell death, rather a process ('prestage') preceding cell death, which can occur through necrosis or apoptosis. The final outcome of MC depends on the molecular profile of the cell.
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                Author and article information

                Journal
                Int J Med Sci
                ijms
                International Journal of Medical Sciences
                Ivyspring International Publisher (Sydney )
                1449-1907
                2012
                27 February 2012
                : 9
                : 3
                : 193-199
                Affiliations
                1. Department of Radiation Oncology, National Cancer Centre, 11- Hospital Drive, Singapore-169610, Singapore;
                2. Division of Cellular and Molecular Research, National Cancer Centre, 11- Hospital Drive, Singapore-169610, Singapore.
                Author notes
                ✉ Corresponding author: R. Baskar, M.Phil, Ph.D., Department of Radiation Oncology, Molecular Radiation Biology Laboratory, Division of Cellular and Molecular Research, National Cancer Centre, 11- Hospital Drive, Singapore-169610, Tel: +65- 6436 8315 ; Fax: +65-6222 8675. E-mail: r.baskar@ 123456nccs.com.sg . OR Kheng-Wei Yeoh, MBBS, MRCP, MPH, FRCR, Department of Radiation Oncology, Division of Cellular and Molecular Research, National Cancer Centre, 11- Hospital Drive, Singapore-169610, Tel: +65- 6436 8315 ; Fax: +65-6222 8675. E-mail: yeoh.kheng.wei@ 123456nccs.com.sg .

                Conflict of Interest: The authors declare that they have no competing interests.

                Article
                ijmsv09p0193
                10.7150/ijms.3635
                3298009
                22408567
                9f0a46d4-4112-4886-bf15-91872cb91397
                © Ivyspring International Publisher. This is an open-access article distributed under the terms of the Creative Commons License (http://creativecommons.org/licenses/by-nc-nd/3.0/). Reproduction is permitted for personal, noncommercial use, provided that the article is in whole, unmodified, and properly cited.
                History
                : 12 October 2011
                : 29 December 2011
                Categories
                Review

                Medicine
                cell death.,radiation therapy,cancer,linear energy transfer
                Medicine
                cell death., radiation therapy, cancer, linear energy transfer

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