Preclinical study of reirradiation with hyperthermia in recurrent murine tumors and normal mouse skin

Background: Re-irradiation is an essential treatment option for recurrent tumours but is limited by normal tissue tolerance. Hyperthermia can enhance radiation efficacy by impairing DNA repair and improving tumor oxygenation; however, limited preclinical data are evaluating its combination with re-i...

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Main Authors: Charlemagne A Folefac, Priyanshu M. Sinha, Niels Bassler, Brita S. Sørensen, Michael R. Horsman
Format: Article
Language:English
Published: Medical Journals Sweden 2025-07-01
Series:Acta Oncologica
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Online Access:https://medicaljournalssweden.se/actaoncologica/article/view/43995
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author Charlemagne A Folefac
Priyanshu M. Sinha
Niels Bassler
Brita S. Sørensen
Michael R. Horsman
author_facet Charlemagne A Folefac
Priyanshu M. Sinha
Niels Bassler
Brita S. Sørensen
Michael R. Horsman
author_sort Charlemagne A Folefac
collection DOAJ
description Background: Re-irradiation is an essential treatment option for recurrent tumours but is limited by normal tissue tolerance. Hyperthermia can enhance radiation efficacy by impairing DNA repair and improving tumor oxygenation; however, limited preclinical data are evaluating its combination with re-irradiation in recurrent tumor settings and normal skin. Objective: The study aims to determine optimal priming doses for skin and tumor response and evaluate the radiosensitising effect of hyperthermia when combined with re-irradiation in preclinical models. Methods: The right rear foot of non-tumor-bearing CDF1 mice or a C3H mammary carcinoma implanted in the foot were treated with a single radiation dose or reirradiation + hyperthermia (42.5°C, 1-h). Initial experiments identified a priming dose of 30 Gy that induced moderate but reversible acute skin toxicity and a tumor dose of 40 Gy that resulted in full regression with regrowth in 30–35 days from treatment. Reirradiation dose–response studies were conducted to determine the MDD₅₀ (skin) and TCD₅₀ (tumor) with and without hyperthermia. Thermal Enhancement Ratios (TER) and Therapeutic Gain Factor (TGF) were calculated. Results: The MDD₅₀ for reirradiation-induced skin damage was 25 Gy, reduced to 18 Gy with hyperthermia (TER = 1.4). In tumours, the TCD₅₀ decreased from 49 Gy (reirradiation alone) to 29 Gy with hyperthermia (TER = 1.7). A TGF of 1.2 was observed, indicating selective enhancement of tumor response relative to skin toxicity. Conclusion: Hyperthermia enhances the therapeutic effect of reirradiation by improving tumor control at lower doses, supporting its potential in recurrent cancer treatment strategies.
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spelling doaj-art-dc5e9fca334945d2a3eae95976b5fbc62025-08-20T03:08:55ZengMedical Journals SwedenActa Oncologica1651-226X2025-07-016410.2340/1651-226X.2025.43995Preclinical study of reirradiation with hyperthermia in recurrent murine tumors and normal mouse skinCharlemagne A Folefac0https://orcid.org/0009-0002-4001-7547Priyanshu M. Sinha1https://orcid.org/0000-0001-6115-1556Niels Bassler2https://orcid.org/0000-0002-4160-1078Brita S. Sørensen3https://orcid.org/0000-0002-3955-4735Michael R. Horsman4https://orcid.org/0000-0003-1578-5691Experimental Clinical Oncology-Department of Oncology, Aarhus, DenmarkExperimental Clinical Oncology-Department of Oncology, Aarhus, DenmarkDanish Center for Particle Therapy, Aarhus University Hospital, Aarhus, DenmarkExperimental Clinical Oncology-Department of Oncology, Aarhus, Denmark; Danish Center for Particle Therapy, Aarhus University Hospital, Aarhus, DenmarkExperimental Clinical Oncology-Department of Oncology, Aarhus, DenmarkBackground: Re-irradiation is an essential treatment option for recurrent tumours but is limited by normal tissue tolerance. Hyperthermia can enhance radiation efficacy by impairing DNA repair and improving tumor oxygenation; however, limited preclinical data are evaluating its combination with re-irradiation in recurrent tumor settings and normal skin. Objective: The study aims to determine optimal priming doses for skin and tumor response and evaluate the radiosensitising effect of hyperthermia when combined with re-irradiation in preclinical models. Methods: The right rear foot of non-tumor-bearing CDF1 mice or a C3H mammary carcinoma implanted in the foot were treated with a single radiation dose or reirradiation + hyperthermia (42.5°C, 1-h). Initial experiments identified a priming dose of 30 Gy that induced moderate but reversible acute skin toxicity and a tumor dose of 40 Gy that resulted in full regression with regrowth in 30–35 days from treatment. Reirradiation dose–response studies were conducted to determine the MDD₅₀ (skin) and TCD₅₀ (tumor) with and without hyperthermia. Thermal Enhancement Ratios (TER) and Therapeutic Gain Factor (TGF) were calculated. Results: The MDD₅₀ for reirradiation-induced skin damage was 25 Gy, reduced to 18 Gy with hyperthermia (TER = 1.4). In tumours, the TCD₅₀ decreased from 49 Gy (reirradiation alone) to 29 Gy with hyperthermia (TER = 1.7). A TGF of 1.2 was observed, indicating selective enhancement of tumor response relative to skin toxicity. Conclusion: Hyperthermia enhances the therapeutic effect of reirradiation by improving tumor control at lower doses, supporting its potential in recurrent cancer treatment strategies. https://medicaljournalssweden.se/actaoncologica/article/view/43995Re-irradiationHyperthermiaRecurrent tumorTumor ControlAcute toxicity
spellingShingle Charlemagne A Folefac
Priyanshu M. Sinha
Niels Bassler
Brita S. Sørensen
Michael R. Horsman
Preclinical study of reirradiation with hyperthermia in recurrent murine tumors and normal mouse skin
Acta Oncologica
Re-irradiation
Hyperthermia
Recurrent tumor
Tumor Control
Acute toxicity
title Preclinical study of reirradiation with hyperthermia in recurrent murine tumors and normal mouse skin
title_full Preclinical study of reirradiation with hyperthermia in recurrent murine tumors and normal mouse skin
title_fullStr Preclinical study of reirradiation with hyperthermia in recurrent murine tumors and normal mouse skin
title_full_unstemmed Preclinical study of reirradiation with hyperthermia in recurrent murine tumors and normal mouse skin
title_short Preclinical study of reirradiation with hyperthermia in recurrent murine tumors and normal mouse skin
title_sort preclinical study of reirradiation with hyperthermia in recurrent murine tumors and normal mouse skin
topic Re-irradiation
Hyperthermia
Recurrent tumor
Tumor Control
Acute toxicity
url https://medicaljournalssweden.se/actaoncologica/article/view/43995
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AT nielsbassler preclinicalstudyofreirradiationwithhyperthermiainrecurrentmurinetumorsandnormalmouseskin
AT britassørensen preclinicalstudyofreirradiationwithhyperthermiainrecurrentmurinetumorsandnormalmouseskin
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