Brain metastases: Radiobiological, molecular and biochemical approach

Abstract

Radiotherapy has made remarkable technological progress in recent years. The accuracy of radiotherapy has improved significantly, and accordingly, the treatment of tumors with high-dose radiation has become possible. Stereotactic radiosurgery has become a rapidly accepted method for the treatment of solid small-sized tumors. Compared to conventional fractionation radiotherapy, stereotactic radiosurgery with a very high dose per fraction and hypofractionated radiotherapy provides satisfactory therapeutic efficiency with low toxicity as tumor cells can be ablated directly with this method. Stereotactic radiosurgery is known to induce radiobiological changes by playing an important role in tumor control, vascular endothelial damage and immune activation. Yet, the literature lacks a comprehensive review on the effects of stereotactic radiosurgery on molecular, genomic and biochemical structures. In this review, we discuss the role of radiobiology in stereotactic radiosurgery of brain metastases, radiobiological factors, genomic profile of brain metastases and biochemical factors.