Abstract
The literature review describes the importance of vascular mechanisms in the implementation of radiobiological effects of high-dose radiation therapy. The basic concepts of radiobiology can be reduced to several closely interrelated models: linear-quadratic, vascular, immune and nontarget. Each of them describes its own link of the cumulative response to the irradiation, and their role and contribution vary depending, first of all, on single doses, and then on fractionation modes and total doses. The accumulated data indicate the expediency of forming a single generalizing model.
The vascular network is important in the proliferation and survival of tumor cells, largely determining the conditions of the microenvironment and the overall response to radiation therapy. High radiation doses per fraction (more than 10 GY) lead to vascular endothelial apoptosis, immediate severe vascular reaction and deep tumor ischemia. This phenomenon is associated with the activation of acidic sphingomyelinase, followed by hydrolysis of sphingomyelin, which generates ceramide, inducing a transmembrane signal of apoptosis.
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