The impact of hypoxia and its modification of the outcome of radiotherapy

Open-access review of tumor hypoxia in radiotherapy. It traces the history from the early 1900s to Gray's work in the 1950s, describes chronic (diffusion-limited) and acute (fluctuating blood flow) hypoxia, reviews attempts to modify hypoxia — including nitroimidazole radiosensitizers, where nimorazole in head and neck cancer is the only one incorporated into standard treatment, and only in Denmark — and notes that although OER falls as LET rises, the oxygen effect only disappears at around 500 keV/µm or greater, beyond what can be achieved clinically. Full text read in Europe PMC (PMC4990104).

A readable overview of tumor hypoxia: where it comes from, how it has been measured and modified, and why high-LET radiation reduces but does not remove the problem.