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Review
. 2020 Apr 25;11(14):4193-4204.
doi: 10.7150/jca.39354. eCollection 2020.

Multiple Mechanisms Involving in Radioresistance of Nasopharyngeal Carcinoma

Yuting Zhan  1 , Songqing Fan  1
Affiliations
Review

Multiple Mechanisms Involving in Radioresistance of Nasopharyngeal Carcinoma

Yuting Zhan et al. J Cancer. .

Abstract

Nasopharyngeal carcinoma (NPC) is the malignant tumor with ethnic and geographical distribution preference. Although intensity-modulated radiotherapy (IMRT)-based radiotherapy combined with chemotherapy and targeted therapy has dramatically improved the overall survival of NPC patients, there are still some patients suffering from recurrent tumors and the prognosis is poor. Multiple mechanisms may be responsible for radioresistance of NPC, such as cancer stem cells (CSCs) existence, gene mutation or aberrant expression of genes, epigenetic modification of genes, abnormal activation of certain signaling pathways, alteration of tumor microenvironment, stress granules (SGs) formation, etc. We conduct a comprehensive review of the published literatures focusing on the causes of radioresistance, retrospect the regulation mechanisms following radiation, and discuss future directions of overcoming the resistance to radiation.

Keywords: mechanism; nasopharyngeal carcinoma; radioresistance.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interest exists.

Figures

Figure 1
Figure 1
Multiple signaling pathways are involved in radiotherapy resistance of NPC. CSCs, EMT process and radiotherapy resistance of NPC is regulated by a network of signaling pathways such as Wnt/β-catenin, NF-κB, Notch, AKT, Hedgehog, etc.
Figure 2
Figure 2
Mechanisms involving in radioresistance of nasopharyngeal carcinoma. A network of signaling pathways participate in the EMT process, cancer stem cell formation/phenotype as well as radiotherapy resistance. Besides, multiple genes can interact with signaling pathways to regulate radiosensitivity, and their encoding proteins can act as potential biomarkers for predicting the reaction for radiotherapy. Epigenetics can regulate radioresistance of NPC as well. Moreover, it cannot be ignored for the roles of EBV products contributing to the aggressiveness and radioresistance of NPC, along with its roles in regulating microenvironment. Stress granules formation also participates in the radioresistance of nasopharyngeal carcinoma.
See this image and copyright information in PMC

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