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

energy, highlighting the significant impact of radiotherapy stereotactic body radiation therapy. Liquid chromatography-
on lipid metabolism in head-and-neck squamous cell tandem mass spectrometry-based metabolomics revealed
carcinoma patients. 8 increased serum fatty acids and glycerophospholipid post-
stereotactic body radiation therapy, suggesting radiation-
2.2. Thoracic tumors induced lipid metabolic alterations. 17
Lung cancer is the most commonly diagnosed cancer, with In prostate cancer, an analysis of 91 patients demonstrated
approximately 1.8 million new cases each year. It is also significant reductions in high-density lipoprotein (HDL)
the leading cause of cancer-related deaths, accounting for levels post-radiotherapy (p=0.0159). Similarly, Shaikh
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approximately 1.59 million deaths annually. Sphingosine- et al. reported decreased TC (224.4 – 150.2 mg/dL) and
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1-phosphate (S1P), a bioactive lipid, has been implicated LDL cholesterol (142.9 – 89.8 mg/dL) levels in 130 breast
in lung cancer progression and treatment resistance. Tang cancer patients following radiotherapy. 19
et al. analyzed serum S1P levels in 256 lung cancer patients,
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revealing significantly lower levels in the 124 patients Giskeødegård et al. conducted a comprehensive study
receiving radiotherapy than in non-radiotherapy patients on 250 breast cancer patients receiving postoperative
(222.13 s 48.63 vs. 315.16 ± 51.06). This inverse correlation radiotherapy, utilizing nuclear magnetic resonance
(Spearman’s rho = −0.653, p<0.001) suggests radiotherapy- spectroscopy to quantify serum metabolites and lipoprotein
induced modulation of S1P signaling. Lv et al. conducted a subfractions. The study revealed reduced esterified
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prospective study using mass spectrometry to analyze plasma cholesterol levels across HDL subfractions, increased free
lipid profiles in 31 advanced non-small cell lung cancer cholesterol levels, and elevated LDL particle numbers,
patients before and after radiotherapy. Significant reductions resulting in increased LDL cholesterol and TG levels post-
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in phosphatidylserine, TC, and phosphatidylinositol radiotherapy. These findings collectively indicate that
(PI) levels were observed post-radiotherapy, indicating radiotherapy induces significant alterations in serum lipid
substantial alterations in lipid metabolism. 11 concentrations in cancer patients.
In the 2022 global cancer statistics, esophageal cancer 3. The impact of blood lipids on
ranked seventh in incidence among all cancer types and radiotherapy
sixth in mortality. Zemanova et al. investigated plasma
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PC fatty acid composition in 42 patients before and after In summary, radiotherapy is associated with fluctuations in
neoadjuvant chemoradiotherapy in esophageal squamous blood lipid levels in cancer patients. Next, we will explore
cell carcinoma. The study revealed increased levels of how blood lipids influence the efficacy and complications
docosahexaenoic acid and total n-3 polyunsaturated fatty of radiotherapy (Table 2). This exploration will further
acids post-treatment, suggesting radiotherapy-induced guide clinicians in managing patients’ baseline lipid levels
modifications in fatty acid metabolism. 13 before radiotherapy, reducing radiotherapy-related adverse
reactions, and enhancing radiotherapy’s therapeutic effect.
2.3. Abdominal tumors
3.1. The impact of blood lipids on the efficacy of
Cervical cancer ranks fourth in incidence among radiotherapy
malignancies in women, with China and India accounting
for more than one-third of global cases. Among women aged Dyslipidemia is a common comorbidity in cancer patients
20 – 39, cervical cancer is the second leading cause of cancer- and, to some extent, reflects underlying lipid metabolism
related mortality. Xu et al. employed metabolomics- disorders. Some studies have explored the correlation
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based liquid chromatography-tandem mass spectrometry between blood lipid levels and radiotherapy outcomes
to analyze plasma-free fatty acid profiles in 114 cervical in cancer patients, providing a lipid-based perspective
cancer patients, including 40 undergoing concurrent for optimizing individualized radiotherapy strategies. In
chemoradiotherapy. While palmitic and stearic acid levels addition, these findings contribute to the development of
decreased post-treatment, most fatty acids, including oleic clinical guidelines for blood lipid management in patients
acid, arachidonic acid, and total n-3 polyunsaturated fatty undergoing radiotherapy.
acids, showed significant increases, indicating complex lipid Huang et al. conducted a retrospective study on
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metabolic changes associated with radiotherapy. 15 140 high-grade glioma patients undergoing intensity-
Hepatocellular carcinoma (HCC) ranks fourth in global modulated radiotherapy. Patients were grouped based on
cancer mortality and is the leading cause of death in cirrhosis. the average levels of TC, LDL, and HDL in peripheral blood
HCC has an extremely poor prognosis, with a mortality rate serum (pre-treatment and 6-month post-treatment) to
nearly equal to its incidence rate. Ng et al. conducted explore whether pre-treatment and post-treatment changes
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a prospective study on 47 HCC patients treated with in these blood lipid levels affected prognosis. Patients with
Volume 3 Issue 2 (2025) 18 doi: 10.36922/ARNM025070006