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World J Stem Cells. Oct 26, 2013; 5(4): 106-111
Published online Oct 26, 2013. doi: 10.4252/wjsc.v5.i4.106
New insights for pelvic radiation disease treatment: Multipotent stromal cell is a promise mainstay treatment for the restoration of abdominopelvic severe chronic damages induced by radiotherapy
Alain Chapel, Sabine Francois, Luc Douay, Marc Benderitter, Jan Voswinkel
Alain Chapel, Sabine Francois, Marc Benderitter, Radiological Protection and Human Health Division, Institute of Radiological Protection and Nuclear Safety, PRP-HOM/SRBE/Laboratory of Radiopathology and Experimental Therapies, 92262 Fontenay-aux-Roses, France
Alain Chapel, Sabine Francois, Luc Douay, Jan Voswinkel, Department of Hematology, Saint Antoine Hospital APHP and UPMC University, UMRS 938 Paris, France
Author contributions: Chapel A participated in research design, conducted experiments, performed data analysis and wrote manuscript; Francois S participated in research design, conducted experiments, performed data analysis; Douay L conducted experiments; Benderitter M conducted experiments; Voswinkel J conducted experiments and wrote manuscript.
Correspondence to: Alain Chapel, PhD, Radiological Protection and Human Health Division, Institute of Radiological Protection and Nuclear Safety, PRP-HOM/SRBE/Laboratory of Radiopathology and Experimental Therapy, BP17, 92262 Fontenay-aux-Roses, France. alain.chapel@irsn.fr
Telephone: +33-1-58359546 Fax: +33-1-58358467
Received: November 27, 2012
Revised: May 22, 2013
Accepted: August 28, 2013
Published online: October 26, 2013
Abstract

Radiotherapy may induce irreversible damage on healthy tissues surrounding the tumor. It has been reported that the majority of patients receiving pelvic radiation therapy show early or late tissue reactions of graded severity as radiotherapy affects not only the targeted tumor cells but also the surrounding healthy tissues. The late adverse effects of pelvic radiotherapy concern 5% to 10% of them, which could be life threatening. However, a clear medical consensus concerning the clinical management of such healthy tissue sequelae does not exist. Although no pharmacologic interventions have yet been proven to efficiently mitigate radiotherapy severe side effects, few preclinical researches show the potential of combined and sequential pharmacological treatments to prevent the onset of tissue damage. Our group has demonstrated in preclinical animal models that systemic mesenchymal stromal cell (MSC) injection is a promising approach for the medical management of gastrointestinal disorder after irradiation. We have shown that MSCs migrate to damaged tissues and restore gut functions after irradiation. We carefully studied side effects of stem cell injection for further application in patients. We have shown that clinical status of four patients suffering from severe pelvic side effects resulting from an over-dosage was improved following MSC injection in a compationnal situation.

Keywords: Cell therapy, Radiotherapy, Irradiation, Stem cells, Multipotent stromal cells, Mesenchymal stem cells, Clinical trial

Core tip: Multipotent stromal cells (MSCs) provide a long-term effect in inhibition of chronic inflammation and a fistulisation, arrest of hemorrhagic syndromes for the hemorrhagic cystitis. MSCs are successfully used to treat the late effects of radiotherapies for breast cancer and radiodermatitis. Their efficiency was also demonstrated on pain reduction. Concerning clinical trials to cure abdominal late severe damages of radiotherapy, one compassionate trial has demonstrated the feasibility of cell therapy treatment for patients overdosed.