Effect of radiation-induced injury of tumor bed stroma on metastatic spread of murine sarcomas and carcinomas.

The study was performed to determine whether irradiation of the tumor bed alters the propensity of tumors to metastasize, and if so, whether the effect is dependent on the property of tumors to exhibit the tumor bed effect (TBE). Ten tumors, of which 5 were sarcomas and 5 were carcinomas syngeneic to C3Hf/Kam mice, were used. Tumors were grown s.c. in the right thighs of mice that had or had not been irradiated with 20-Gy gamma-rays 1 day before tumor cell transplantation. All 5 carcinomas and 2 of 5 sarcomas exhibited TBE, as assessed by a significant retardation of growth rate. To test whether irradiation of the tumor bed influenced metastatic spread independently of TBE, tumors of various sizes were surgically removed, and at appropriate times thereafter the lungs were examined for the presence of metastases. All tumors that exhibited TBE, and only 1 of 3 tumors that did not exhibit TBE, metastasized more than tumors of the same size growing in an unirradiated tumor bed. TBE-induced enhancement of metastasis was not seen in tumors less than approximately 7 mm in diameter. All tumors, whether they exhibited TBE or not, were more necrotic if they grew in a preirradiated tumor bed. These observations show that size for size, most tumors growing in irradiated tissues have an increased propensity to metastasize, which is linked to their manifestation of TBE. The evidence presented suggests that TBE-induced retardation of tumor growth is the major factor responsible for the observed enhancement of metastasis. The clinical implication of these findings is that tumors recurrent after radiotherapy should be diagnosed and treated promptly to reduce the risk of metastatic spread.