The influence of tumor blood flow and microenvironmental factors on the efficacy of radiation, drugs and localized hyperthermia

Klin Padiatr. Jul-Aug 1997;209(4):243-9. doi: 10.1055/s-2008-1043957.


It is generally accepted that tumor blood flow, microcirculation, oxygen and nutrient supply, tissue pH distribution, and the bioenergetic status-factors which are usually closely linked and which define the so-called metabolic microenvironment--can markedly influence the therapeutic response of malignant tumors to conventional irradiation, chemotherapy, other nonsurgical treatment modalities, and the cell proliferation activity within tumors. Currently available information on the parameters defining the metabolic micromilieu in human tumors is presented in this review. According to these data, significant variations in these relevant factors are likely to occur between different locations within a tumor, and between tumors of the same grade and clinical stage. The extent and mechanisms by which the microenvironmental factors influence cellular response to standard irradiation, chemotherapeutic drugs, immunotherapy and localized hyperthermia are described and "physiological" barriers to treatment are outlined.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Animals
  • Cell Division / drug effects
  • Cell Division / physiology
  • Cell Division / radiation effects
  • Cell Hypoxia / drug effects
  • Cell Hypoxia / physiology*
  • Cell Hypoxia / radiation effects
  • Cell Survival / drug effects
  • Cell Survival / physiology
  • Cell Survival / radiation effects
  • Chemotherapy, Adjuvant
  • Child
  • Combined Modality Therapy
  • Energy Metabolism / drug effects
  • Energy Metabolism / physiology
  • Energy Metabolism / radiation effects
  • Humans
  • Hyperthermia, Induced
  • Immunotherapy
  • Neoplasms / blood supply*
  • Neoplasms / therapy*
  • Prognosis
  • Radiotherapy, Adjuvant
  • Regional Blood Flow / drug effects
  • Regional Blood Flow / physiology
  • Regional Blood Flow / radiation effects