Cited by 1,050Cancer, Hypoxia, and MetabolismMathematical Biology Tumor GrowthAngiogenesis and VEGF in Cancer

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Defining normoxia, physoxia and hypoxia in tumours—implications for treatment response

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McKeown, S R·2014·The British Journal of Radiology

DOI 10.1259/bjr.20130676PMC PMC4064601

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Abstract

Tumour hypoxia is increasingly recognized as a major deleterious factor in cancer therapies, as it compromises treatment and drives malignant progression. This review seeks to clarify the oxygen levels that are pertinent to this issue. It is argued that normoxia (20% oxygen) is an extremely poor comparator for "physoxia", i.e. the much lower levels of oxygen universally found in normal tissues, which averages about 5% oxygen, and ranges from about 3% to 7.4%. Importantly, it should be recognized that the median oxygenation in untreated tumours is significantly much lower, falling between approximately 0.3% and 4.2% oxygen, with most tumours exhibiting median oxygen levels <2%. This is partially dependent on the tissue of origin, and it is notable that many prostate and pancreatic tumours are profoundly hypoxic. In addition, therapy can induce even further, often unrecognized, changes in tumour oxygenation that may vary longitudinally, increasing or decreasing during treatment in ways that are not always predictable. Studies that fail to take cognizance of the actual physiological levels of oxygen in tissues (approximately 5%) and tumours (approximately 1%) may fail to identify the real circumstances driving tumour response to treatment and/or malignant progression. This can be of particular importance in genetic studies in vitro when comparison to human tumours is required.

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Authors: McKeown, S. R.
Affiliations: University of Ulster (GB)
Corresponding author: McKeown, S R
Venue: The British Journal of Radiology
Publisher: Oxford University Press (OUP)
Published: 2014-03
Volume: 87
Issue: 1035
Pages: 20130676
ISSN: 0007-1285 (ISSN-L)
1748-880X
DOI: 10.1259/bjr.20130676
PMC: PMC4064601
OpenAlex: W2018722597
Cited by: 1,050
References: 126
Citations by year: 2026: 84 · 2025: 122 · 2024: 129 · 2023: 139 · 2022: 137 · 2021: 152 · 2020: 107 · 2019: 68 · 2018: 56 · 2017: 33 · 2016: 13 · 2015: 5 · 2014: 4
FWCI: 1.82
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Locations: British Journal of Radiology (publishedVersion)
Europe PMC (PubMed Central) (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
Topics: Life Sciences › Biochemistry, Genetics and Molecular Biology › Cancer Research › Cancer, Hypoxia, and Metabolism
Physical Sciences › Mathematics › Modeling and Simulation › Mathematical Biology Tumor Growth
Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Angiogenesis and VEGF in Cancer
Keywords: tumor hypoxia, tumor oxygenation, normoxia, treatment response, prostate cancer, pancreatic cancer, malignant progression
MeSH terms: Animals, Hypoxia, Humans, Male, Neoplasms, Oxygen, Cell Hypoxia, Disease Progression

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Defining normoxia, physoxia and hypoxia in tumours—implications for treatment response

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