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Advances in Radiotherapy
& Nuclear Medicine Lipid-radiotherapy crosstalk in cancer

Conversely, blood lipid levels can influence radiotherapy’s 2.1. Head-and-neck tumors
efficacy and safety profile. Squamous cell carcinoma is the predominant histological
This review aims to provide a comprehensive analysis type of head-and-neck cancer, accounting for over 90% of
of current clinical studies, focusing on the effects of all cases. In 2022, there were approximately 660,740 newly
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radiotherapy on blood lipid levels and the impact of diagnosed cases worldwide. Smoking, heavy alcohol
blood lipids on radiotherapy outcomes. The ultimate goal consumption, and human papillomavirus infection
is to offer evidence-based insights for optimizing lipid are the most significant risk factors for head-and-neck
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management in radiotherapy patients. cancer. Jelonek et al. conducted a study on head-and-
neck squamous cell carcinoma patients, dividing them
2. The impact of radiotherapy on blood into three treatment groups: radiotherapy alone (n = 18),
lipids in cancer patients concurrent chemoradiotherapy with cisplatin (n = 16),
and chemotherapy alone (n = 13). Mass spectrometry
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A systematic literature search was conducted across analysis of pre- and post-treatment serum samples
PubMed, EMBASE, Cochrane Library, and Web of revealed significant decreases in phosphatidylcholine (PC)
Science, yielding 10 relevant studies (Table 1). Despite levels in both radiotherapy groups, with more pronounced
methodological and population differences, all studies reductions in the concurrent chemoradiotherapy group.
consistently demonstrated that radiotherapy significantly Subsequent analysis demonstrated a negative correlation
alters blood lipid profiles in cancer patients. between serum PC levels and radiation dose/absorbed

Table 1. Radiotherapy effects on blood lipid levels in cancer patients
Author (s) Year Diagnosis Tumor staging Sample Method Types of Effect Baseline
size lipids
Jelonek et al. 7 2020 HNSCC TxNxM0 47 LC-MS PCs Low -
Jelonek et al. 8 2021 HNSCC TxNxM0 45 LC-MS PCs Low -
Tang et al. 10 2020 Lung cancer NA 256 LC-MS S1P Low Receiving
radiotherapy
compared to
non-radiotherapy
patients
(222.13±48.63 vs.
315.16±51.06)
Lv et al. 11 2024 NSCLC Histology grade III–IV 31 LC-MS PS, PI, and Low -
TC
Zemanova et al. 13 2016 ESCC Histology grade II–III 42 LC-MS PC High Healthy compared
to patients
(5.53±1.23 vs.
5.17±1.11)
Xu et al. 15 2024 Cervical cancer Histology grade I–IV 114 LC-MS FFA Most high -
Ng et al. 17 2020 HCC NA 47 LC-MS FFA and High -
GPL
Wolny-Rokicka et al. 18 2019 Prostate cancer NA 91 Roche/Hitachi HDL Low -
Cobas C
Systems
Shaikh et al. 19 2017 Breast cancer NA 130 Gas TC and Low -
chromatography LDL-C
Giskeødegård et al. 20 2022 Breast cancer I–III 250 NMR HDL, HDL low, -
spectroscopy LDL-C, and LDL-C high,
TG and TG high
Note: NA refers to not available.
Abbreviations: ESCC: Esophageal squamous cell carcinoma; FFA: Free fatty acids; GPL: Glycerophospholipids; HCC: Hepatocellular carcinoma;
HDL: High-density lipoprotein; HNSCC: Head-and-neck squamous cell carcinoma; LC-MS: Liquid chromatography-mass spectrometry;
LDL-C: Low-density lipoprotein cholesterol; NMR spectroscopy: Nuclear magnetic resonance spectroscopy; NSCLC: Non-small cell lung cancer;
PC: Phosphatidylcholine; PI: Phosphatidylinositol; PS: Phosphatidylserine; S1P: Sphingosine-1-phosphate; TC: Total cholesterol; TG: Triglycerides.

Volume 3 Issue 2 (2025) 17 doi: 10.36922/ARNM025070006