Cancerstemcells:Radioresistance,predictionofradiotherapyoutcomeandspecifictargetsforcombinedtreatments☆MechthildKrausea,b,c,d,e,⁎,AnnaDubrovskaa,c,e,AnnettLingea,b,c,e,MichaelBaumanna,b,c,d,eaGermanCancerConsortium(DKTK)Dresden,GermanybDept.ofRadiationOncology,TechnischeUniversitätDresden,GermanycOncoRay,FacultyofMedicineandUniversityHospitalCarlGustavCarus,TechnischeUniversitätDresden,GermanydHelmholtz-ZentrumDresden-Rossendorf,GermanyeGermanCancerResearchCenter(DKFZ)Heidelberg,GermanyabstractarticleinfoArticlehistory:Received21September2015Receivedinrevisedform5January2016Accepted3February2016Availableonline12February2016Inactivationofcancerstemcells(CSCs)isofutmostimportancefortumorcureafterradiotherapy.AnincreasingbodyofevidencecomplieswithahigherradioresistanceofCSCscomparedtothemassoftumorcells,supportingtheuseofCSCrelatedbiomarkersforpredictionofradiotherapyoutcome.Treatmentindividualizationstrategiesforpatientgroupswithvastlydifferentriskofrecurrencewillmostlikelyrequireapplicationofmorethanonebiomarker.Specifically,inclusionofestablishedbiomarkersliketumorsizeforprimaryradio(chemo)therapyorhumanpapillomavirus(HPV)infectionstatusinheadandnecksquamouscellcarcinomaseemstobeofveryhighrelevance.ThehighheterogeneityofCSCsubclonesalongwithchangesofthefunctionalbehaviorofindividualtumorsundertreatmentunderlinestheimportanceoftheselectionoftheoptimaltimepoint(s)ofbio-markerevaluation,butalsoprovidesapotentialtherapeutictargetforcombinedtreatmentapproacheswithirradiation.©2016TheAuthors.PublishedbyElsevierB.V.ThisisanopenaccessarticleundertheCCBY-NC-NDlicense(http://creativecommons.org/licenses/by-nc-nd/4.0/).Keywords:CancerstemcellsRadiotherapyPredictionBiomarkerPrognosisContents1.Introduction...............................................................632.Radioresistancedeterminedbycancerstemcells..............................................643.Cancerstemcellsasprognosticorpredictivebiomarkersinpatienttumors..................................664.Importanc...
