Tumour hypoxia is the inevitable consequence of a tumour’s rapid growth and disorganized,inefficient vasculature.The compensatorymechanisms employed by tumours,and indeed the absence of oxygen itself,hinder the abili...Tumour hypoxia is the inevitable consequence of a tumour’s rapid growth and disorganized,inefficient vasculature.The compensatorymechanisms employed by tumours,and indeed the absence of oxygen itself,hinder the ability of all treatmentmodalities.The clinical consequence is poorer overall survival,disease-free survival,and locoregional control.Recognizing this,clinicians have been attenuating the effect of hypoxia,primarily with hypoxicmodification or with hypoxia-activated prodrugs,and notable success has been demonstrated.However,in the case of colorectal cancer(CRC),there is a general paucity of knowledge and evidence surrounding themeasurement andmodification of hypoxia,and this is possibly due to the comparative inaccessibility of such tumours.We specifically review the role of hypoxia in CRC and focus on the current evidence for the existence of hypoxia in CRC,themajority of which originates from indirect positron emission topography imaging with hypoxia selective radiotracers;the evidence correlating CRC hypoxia with poorer oncological outcome,which is largely based on themeasurement of hypoxia inducible factor in correlation with clinical outcome;the evidence of hypoxicmodification in CRC,of which no direct evidence exists,but is reflected in a number of indirectmarkers;the prognostic andmonitoring implications of accurate CRC hypoxia quantification and its potential in the field of precision oncology;and the present and future imaging tools and technologies being developed for themeasurement of CRC hypoxia,including the use of blood-oxygenlevel-dependentmagnetic resonance imaging and diffuse reflectance spectroscopy.展开更多
基金supported by the National Institute for Health Research(NIHR)Imperial Biomedical Research Centre(BRC).
文摘Tumour hypoxia is the inevitable consequence of a tumour’s rapid growth and disorganized,inefficient vasculature.The compensatorymechanisms employed by tumours,and indeed the absence of oxygen itself,hinder the ability of all treatmentmodalities.The clinical consequence is poorer overall survival,disease-free survival,and locoregional control.Recognizing this,clinicians have been attenuating the effect of hypoxia,primarily with hypoxicmodification or with hypoxia-activated prodrugs,and notable success has been demonstrated.However,in the case of colorectal cancer(CRC),there is a general paucity of knowledge and evidence surrounding themeasurement andmodification of hypoxia,and this is possibly due to the comparative inaccessibility of such tumours.We specifically review the role of hypoxia in CRC and focus on the current evidence for the existence of hypoxia in CRC,themajority of which originates from indirect positron emission topography imaging with hypoxia selective radiotracers;the evidence correlating CRC hypoxia with poorer oncological outcome,which is largely based on themeasurement of hypoxia inducible factor in correlation with clinical outcome;the evidence of hypoxicmodification in CRC,of which no direct evidence exists,but is reflected in a number of indirectmarkers;the prognostic andmonitoring implications of accurate CRC hypoxia quantification and its potential in the field of precision oncology;and the present and future imaging tools and technologies being developed for themeasurement of CRC hypoxia,including the use of blood-oxygenlevel-dependentmagnetic resonance imaging and diffuse reflectance spectroscopy.
