ABSTRACT
Hypoxia is a condition arising from an imbalance between oxygen production and consumption in cells, commonly observed in solid tumors. Hypoxic cells, indicative of increased angiogenesis, invasion, metastasis, metabolic changes, and genomic instability, also serve as markers for treatment resistance and poor prognosis. Pharmacological interventions aimed at overcoming tumor hypoxia during radiotherapy include prodrugs selectively activated in hypoxic cells or inhibitors targeting molecular factors crucial for hypoxic cell survival. Despite these efforts, such interventions have not gained sufficient traction in clinical settings for various reasons. However, identifying patients who would benefit most from strategies targeting hypoxia is critical. Modifying radiotherapy doses in hypoxic areas may significantly impact tumor control. In the era of modern radiotherapy techniques, imaging methods allowing visualization of hypoxic regions within tumors have the potential to modify radiotherapy planning and prescription. Knowledge regarding the use of hypoxia-specific radiopharmaceuticals in positron emission tomography for radiotherapy is expanding. This review aims to explore the role of hypoxia imaging markers in characterizing tumor hypoxia behavior during radiotherapy, with the goal of developing personalized treatments for both the tumor and the patient.
Keywords:
Hypoxia imaging markers, PET, radiotherapy, tumor hypoxia
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