Epigenetics in radiotherapy: Where are we heading?

Kim M. Smits*, Veerle Melotte, Hanneke E. C. Niessen, Ludwig Dubois, Cary Oberije, Esther G. C. Troost, Maud H. W. Starmans, Paul C. Boutros, Marc Vooijs, Manon van Engeland, Philippe Lambin

*Corresponding author for this work

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Radiotherapy is an important component of anti-cancer treatment. However, not all cancer patients respond to radiotherapy, and with current knowledge clinicians are unable to predict which patients are at high risk of recurrence after radiotherapy. There is therefore an urgent need for biomarkers to guide clinical decision-making. Although the importance of epigenetic alterations is widely accepted, their application as biomarkers in radiotherapy has not been studied extensively. In addition, it has been suggested that radiotherapy itself introduces epigenetic alterations. As epigenetic alterations can potentially be reversed by drug treatment, they are interesting candidate targets for anticancer therapy or radiotherapy sensitizers. The application of demethylating drugs or histone deacetylase inhibitors to sensitize patients for radiotherapy has been studied in vitro, in vivo as well as in clinical trials with promising results. This review describes the current knowledge on epigenetics in radiotherapy.
Original languageEnglish
Pages (from-to)168-177
JournalRadiotherapy and Oncology
Issue number2
Publication statusPublished - May 2014


  • Epigenetic biomarkers
  • Radiotherapy
  • DNA methylation
  • Histone modifications
  • Hypoxia

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