{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:38:21Z","timestamp":1787027901272,"version":"build-2736575974"},"reference-count":91,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2021,9,8]],"date-time":"2021-09-08T00:00:00Z","timestamp":1631059200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001659","name":"Deutsche Forschungsgemeinschaft","doi-asserted-by":"publisher","award":["WI 830\/12-1"],"award-info":[{"award-number":["WI 830\/12-1"]}],"id":[{"id":"10.13039\/501100001659","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Current Oncology"],"abstract":"<jats:p>Circulating epithelial tumor cells (CETC) are considered to be responsible for the formation of metastases. Therefore, their importance as prognostic and\/or predictive markers in breast cancer is being intensively investigated. Here, the reliability of single cell expression analyses in isolated and collected CETC from whole blood samples of patients with early-stage breast cancer before and after radiotherapy (RT) using the maintrac\u00ae method was investigated. Single-cell expression analyses were performed with qRT-PCR on a panel of selected genes: GAPDH, EpCAM, NANOG, Bcl-2, TLR 4, COX-2, PIK3CA, Her-2\/neu, Vimentin, c-Met, Ki-67. In all patients, viable CETC were detected prior to and at the end of radiotherapy. In 7 of the 9 (77.8%) subjects examined, the CETC number at the end of the radiotherapy series was higher than before. The majority of genes analyzed showed increased expression after completion of radiotherapy compared to baseline. Procedures and methods used in this pilot study proved to be feasible. The method is suitable for further investigation of the underlying molecular biological mechanisms occurring in cells surviving radiotherapy and possibly the development of radiation resistance.<\/jats:p>","DOI":"10.3390\/curroncol28050302","type":"journal-article","created":{"date-parts":[[2021,9,8]],"date-time":"2021-09-08T10:12:03Z","timestamp":1631095923000},"page":"3507-3524","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Prospective Monitoring of Circulating Epithelial Tumor Cells (CETC) Reveals Changes in Gene Expression during Adjuvant Radiotherapy of Breast Cancer Patients"],"prefix":"10.3390","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9662-3082","authenticated-orcid":false,"given":"Matthias","family":"M\u00e4urer","sequence":"first","affiliation":[{"name":"Department of Radiotherapy and Radiation Oncology, University Hospital Jena, Bachstra\u00dfe 18, 07743 Jena, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katharina","family":"Pachmann","sequence":"additional","affiliation":[{"name":"Transfusion Center Bayreuth, Kurpromenade 2, 95448 Bayreuth, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Wendt","sequence":"additional","affiliation":[{"name":"Department of Radiotherapy and Radiation Oncology, University Hospital Jena, Bachstra\u00dfe 18, 07743 Jena, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dorothea","family":"Schott","sequence":"additional","affiliation":[{"name":"Transfusion Center Bayreuth, Kurpromenade 2, 95448 Bayreuth, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Wittig","sequence":"additional","affiliation":[{"name":"Department of Radiotherapy and Radiation Oncology, University Hospital Jena, Bachstra\u00dfe 18, 07743 Jena, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,9,8]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1707","DOI":"10.1016\/S0140-6736(11)61629-2","article-title":"Effect of radiotherapy after breast-conserving surgery on 10-year recurrence and 15-year breast cancer death: Meta-analysis of individual patient data for 10,801 women in 17 randomised trials","volume":"378","author":"Darby","year":"2011","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"256","DOI":"10.1016\/j.ygyno.2003.09.009","article-title":"Detection of disseminated tumor cells in peripheral blood of patients with breast cancer: Correlation to nodal status and occurrence of metastases","volume":"92","author":"Taubert","year":"2004","journal-title":"Gynecol. Oncol."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Fabisiewicz, A., Szostakowska-Rodzos, M., Zaczek, A.J., and Grzybowska, E.A. (2020). Circulating tumor cells in early and advanced breast cancer; biology and prognostic value. Int. J. Mol. Sci., 21.","DOI":"10.3390\/ijms21051671"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1016\/j.semcancer.2017.08.010","article-title":"Prognostic and predictive biomarkers in breast cancer: Past, present and future","volume":"52","author":"Nicolini","year":"2018","journal-title":"Semin. Cancer Biol."},{"key":"ref_5","first-page":"6326","article-title":"Detection and clinical implications of early systemic tumor cell dissemination in breast cancer","volume":"9","author":"Pantel","year":"2003","journal-title":"Clin. Cancer Res."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"e180163","DOI":"10.1001\/jamaoncol.2018.0163","article-title":"Association of circulating tumor cell status with benefit of radiotherapy and survival in early-stage breast cancer","volume":"4","author":"Goodman","year":"2018","journal-title":"JAMA Oncol."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Reinhardt, F., Franken, A., Meier-Stiegen, F., Driemel, C., Stoecklein, N.H., Fischer, J.C., Niederacher, D., Ruckhaeberle, E., Fehm, T., and Neubauer, H. (2019). Diagnostic leukapheresis enables reliable transcriptomic profiling of single circulating tumor cells to characterize inter-cellular heterogeneity in terms of endocrine resistance. Cancers, 11.","DOI":"10.3390\/cancers11070903"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1007\/978-3-030-26439-0_7","article-title":"Circulating tumor cells in breast cancer","volume":"215","author":"Liang","year":"2020","journal-title":"Recent Results Cancer Res."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"2583","DOI":"10.1158\/1078-0432.CCR-15-1603","article-title":"Pooled analysis of the prognostic relevance of circulating tumor cells in primary breast cancer","volume":"22","author":"Janni","year":"2016","journal-title":"Clin. Cancer Res."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"2372","DOI":"10.1158\/1078-0432.CCR-19-2158","article-title":"Circulating tumor cells are associated with recurrent disease in patients with early-stage non-small cell lung cancer treated with stereotactic body radiotherapy","volume":"26","author":"Frick","year":"2020","journal-title":"Clin. Cancer Res."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1208","DOI":"10.1200\/JCO.2007.13.6523","article-title":"Monitoring the response of circulating epithelial tumor cells to adjuvant chemotherapy in breast cancer allows detection of patients at risk of early relapse","volume":"26","author":"Pachmann","year":"2008","journal-title":"J. Clin. Oncol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"406","DOI":"10.1016\/S1470-2045(14)70069-5","article-title":"Clinical validity of circulating tumour cells in patients with metastatic breast cancer: A pooled analysis of individual patient data","volume":"15","author":"Bidard","year":"2014","journal-title":"Lancet Oncol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1420","DOI":"10.1200\/JCO.2005.08.140","article-title":"Circulating tumor cells: A novel prognostic factor for newly diagnosed metastatic breast cancer","volume":"23","author":"Cristofanilli","year":"2005","journal-title":"J. Clin. Oncol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"2","DOI":"10.31768\/2312-8852.2017.39(1):2-11","article-title":"Circulating tumor cells in breast cancer: Functional heterogeneity, pathogenetic and clinical aspects","volume":"39","author":"Cherdyntseva","year":"2017","journal-title":"Exp. Oncol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"539","DOI":"10.1038\/nbt.2576","article-title":"Identification of a population of blood circulating tumor cells from breast cancer patients that initiates metastasis in a xenograft assay","volume":"31","author":"Baccelli","year":"2013","journal-title":"Nat. Biotechnol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1615\/CritRevOncog.2016016120","article-title":"Circulating tumor cells in breast cancer patients","volume":"21","author":"Hall","year":"2016","journal-title":"Crit. Rev. Oncog."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"491","DOI":"10.1016\/j.canlet.2014.09.046","article-title":"Determining tissue origin of circulating epithelial cells (cec) in patients with differentiated thyroid cancer by real-time pcr using thyroid mrna probes","volume":"356","author":"Sorg","year":"2015","journal-title":"Cancer Lett."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Lapin, M., Tjensvoll, K., Oltedal, S., Javle, M., Smaaland, R., Gilje, B., and Nordgard, O. (2017). Single-cell mrna profiling reveals transcriptional heterogeneity among pancreatic circulating tumour cells. BMC Cancer, 17.","DOI":"10.1186\/s12885-017-3385-3"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"601","DOI":"10.1007\/s00066-017-1158-1","article-title":"Personalized radiotherapy for invasive breast cancer in 2017 national s3 guidelines and degro and ago recommendations","volume":"193","author":"Wenz","year":"2017","journal-title":"Strahlenther. Onkol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"617","DOI":"10.1515\/CCLM.2005.107","article-title":"Standardized quantification of circulating peripheral tumor cells from lung and breast cancer","volume":"43","author":"Pachmann","year":"2005","journal-title":"Clin. Chem. Lab. Med."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1023\/A:1005658330108","article-title":"Validities of mrna quantification using recombinant rna and recombinant DNA external calibration curves in real-time rt-pcr","volume":"23","author":"Pfaffl","year":"2001","journal-title":"Biotechnol. Lett."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1586\/14737159.2014.901154","article-title":"The workflow of single-cell expression profiling using quantitative real-time pcr","volume":"14","author":"Kubista","year":"2014","journal-title":"Expert Rev. Mol. Diagn."},{"key":"ref_23","unstructured":"M\u00e4urer, M.A. (2014). Analysen Zirkulierender Epithelialer Tumorzellen im Peripherven\u00f6sen blut bei Patientinnen mit Prim\u00e4r nicht Metastasiertem Mammakarzinom unter Adjuvanter Radiotherapie. [Ph.D. Thesis, Friedrich-Schiller-University Jena]."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"S34","DOI":"10.1016\/S0959-8049(13)70185-0","article-title":"Mc13-0080 somatic mutations of the egfr, kras and braf genes: Heterogeneity in circulating epithalial tumor cells (cetc) as determined using the cobas\u00ae z 480 analyzer","volume":"49","author":"Pachmann","year":"2013","journal-title":"Eur. J. Cancer"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"479","DOI":"10.1158\/2159-8290.CD-15-1483","article-title":"Clinical applications of circulating tumor cells and circulating tumor DNA as liquid biopsy","volume":"6","author":"Pantel","year":"2016","journal-title":"Cancer Discov."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"507","DOI":"10.1016\/j.bbrc.2017.08.053","article-title":"Real-time monitoring of circulating tumor cell (ctc) release after nanodrug or tumor radiotherapy using in vivo flow cytometry","volume":"492","author":"Koonce","year":"2017","journal-title":"Biochem. Biophys. Res. Commun."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1007\/s10549-016-4026-2","article-title":"Longitudinally collected ctcs and ctc-clusters and clinical outcomes of metastatic breast cancer","volume":"161","author":"Wang","year":"2017","journal-title":"Breast Cancer Res. Treat."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"581","DOI":"10.1007\/s10549-008-0143-x","article-title":"Molecular profiling and predictive value of circulating tumor cells in patients with metastatic breast cancer: An option for monitoring response to breast cancer related therapies","volume":"115","author":"Tewes","year":"2009","journal-title":"Breast Cancer Res. Treat."},{"key":"ref_29","first-page":"343","article-title":"Heterogeneity of circulating epithelial tumour cells from individual patients with respect to expression profiles and clonal growth (sphere formation) in breast cancer","volume":"7","author":"Pizon","year":"2013","journal-title":"Ecancermedicalscience"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1016\/j.semcdb.2017.09.013","article-title":"Molecular characterization of circulating tumor cells-from bench to bedside","volume":"75","author":"Li","year":"2018","journal-title":"Semin Cell Dev. Biol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"781","DOI":"10.1056\/NEJMoa040766","article-title":"Circulating tumor cells, disease progression, and survival in metastatic breast cancer","volume":"351","author":"Cristofanilli","year":"2004","journal-title":"N. Engl. J. Med."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"R118","DOI":"10.1186\/bcr3243","article-title":"Prognostic impact of circulating tumor cells assessed with the cellsearch system and adnatest breast in metastatic breast cancer patients: The detect study","volume":"14","author":"Muller","year":"2012","journal-title":"Breast Cancer Res."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"920","DOI":"10.1158\/1078-0432.CCR-06-1695","article-title":"Detection of circulating tumor cells in peripheral blood of patients with metastatic breast cancer: A validation study of the cellsearch system","volume":"13","author":"Riethdorf","year":"2007","journal-title":"Clin. Cancer Res."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"891","DOI":"10.1093\/annonc\/mdm558","article-title":"Variation of circulating tumor cell levels during treatment of metastatic breast cancer: Prognostic and therapeutic implications","volume":"19","author":"Nole","year":"2008","journal-title":"Ann. Oncol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"R69","DOI":"10.1186\/bcr2131","article-title":"Enrichment with anti-cytokeratin alone or combined with anti-epcam antibodies significantly increases the sensitivity for circulating tumor cell detection in metastatic breast cancer patients","volume":"10","author":"Deng","year":"2008","journal-title":"Breast Cancer Res."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1851","DOI":"10.1093\/annonc\/mdq030","article-title":"All circulating epcam+ck+cd45- objects predict overall survival in castration-resistant prostate cancer","volume":"21","author":"Coumans","year":"2010","journal-title":"Ann. Oncol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"S1","DOI":"10.1186\/bcr1869","article-title":"Micrometastatic spread in breast cancer: Detection, molecular characterization and clinical relevance","volume":"10","author":"Fehm","year":"2008","journal-title":"Breast Cancer Res."},{"key":"ref_38","first-page":"3219","article-title":"Comparing sequential steps for detection of circulating tumor cells: More specific or just less sensitive?","volume":"37","author":"Pachmann","year":"2011","journal-title":"Oncol. Rep."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"984","DOI":"10.1002\/ijc.11479","article-title":"Detection of breast cancer cells in the peripheral blood is positively correlated with estrogen-receptor status and predicts for poor prognosis","volume":"107","author":"Gaforio","year":"2003","journal-title":"Int. J. Cancer"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1385\/MB:34:1:15","article-title":"Quantitative real-time rt-pcr of disseminated tumor cells in combination with immunomagnetic cell enrichment","volume":"34","author":"Lankiewicz","year":"2006","journal-title":"Mol. Biotechnol."},{"key":"ref_41","first-page":"3317","article-title":"Association of the 323\/a3 surface glycoprotein with tumor characteristics and behavior in human breast cancer","volume":"50","author":"Tandon","year":"1990","journal-title":"Cancer Res."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"699","DOI":"10.1007\/s001099900038","article-title":"The biology of the 17-1a antigen (ep-cam)","volume":"77","author":"Balzar","year":"1999","journal-title":"J. Mol. Med. (Berl)"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"5818","DOI":"10.1158\/0008-5472.CAN-04-0754","article-title":"Epcam is overexpressed in breast cancer and is a potential target for breast cancer gene therapy","volume":"64","author":"Osta","year":"2004","journal-title":"Cancer Res."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"714","DOI":"10.1038\/bjc.1987.276","article-title":"Epithelium-specific surface glycoprotein of mr 34,000 is a widely distributed human carcinoma marker","volume":"56","author":"Moldenhauer","year":"1987","journal-title":"Br. J. Cancer"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"S133","DOI":"10.1097\/00008390-199708001-00021","article-title":"Polymerase chain reaction detection of circulating tumour cells","volume":"7","author":"Keilholz","year":"1997","journal-title":"Melanoma Res."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"16519","DOI":"10.1038\/srep16519","article-title":"Single cell analysis of cancer cells using an improved rt-mlpa method has potential for cancer diagnosis and monitoring","volume":"5","author":"Kvastad","year":"2015","journal-title":"Sci. Rep."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"589","DOI":"10.1038\/sj.bjc.6605183","article-title":"Detection of cytokeratin-19 mrna-positive cells in the peripheral blood and bone marrow of patients with operable breast cancer","volume":"101","author":"Daskalaki","year":"2009","journal-title":"Br. J. Cancer"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1016\/S1525-1578(10)60646-0","article-title":"Validation of array-based gene expression profiles by real-time (kinetic) rt-pcr","volume":"3","author":"Rajeevan","year":"2001","journal-title":"J. Mol. Diagn."},{"key":"ref_49","first-page":"2073","article-title":"Cytogenetic evidence that circulating epithelial cells in patients with carcinoma are malignant","volume":"8","author":"Fehm","year":"2002","journal-title":"Clin. Cancer Res."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"302","DOI":"10.1038\/nrc2627","article-title":"Parallel progression of primary tumours and metastases","volume":"9","author":"Klein","year":"2009","journal-title":"Nat. Rev. Cancer"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"11687","DOI":"10.1158\/0008-5472.CAN-07-1406","article-title":"Tumor irradiation increases the recruitment of circulating mesenchymal stem cells into the tumor microenvironment","volume":"67","author":"Klopp","year":"2007","journal-title":"Cancer Res."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1038\/nrclinonc.2016.128","article-title":"Does the mobilization of circulating tumour cells during cancer therapy cause metastasis?","volume":"14","author":"Martin","year":"2017","journal-title":"Nat. Rev. Clin. Oncol."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1016\/j.ijrobp.2019.11.398","article-title":"Systemic inflammation after radiation predicts locoregional recurrence, progression, and mortality in stage ii-iii triple-negative breast cancer","volume":"108","author":"Sherry","year":"2019","journal-title":"Int. J. Radiat. Oncol. Biol. Phys."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"8152","DOI":"10.1158\/1078-0432.CCR-04-1110","article-title":"Circulating tumor cells in patients with breast cancer dormancy","volume":"10","author":"Meng","year":"2004","journal-title":"Clin. Cancer Res."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"77928","DOI":"10.18632\/oncotarget.18272","article-title":"Meta-analysis of the mutational status of circulation tumor cells and paired primary tumor tissues from colorectal cancer patients","volume":"8","author":"Liu","year":"2017","journal-title":"Oncotarget."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1186\/2047-783X-14-8-359","article-title":"Gene expression of circulating tumour cells and its correlation with tumour stage in breast cancer patients","volume":"14","author":"Bolke","year":"2009","journal-title":"Eur. J. Med. Res."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"707","DOI":"10.1126\/science.2470152","article-title":"Studies of the her-2\/neu proto-oncogene in human breast and ovarian cancer","volume":"244","author":"Slamon","year":"1989","journal-title":"Science"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"701","DOI":"10.1073\/pnas.94.2.701","article-title":"Diverse tumorigenesis associated with aberrant development in mice overexpressing hepatocyte growth factor\/scatter factor","volume":"94","author":"Takayama","year":"1997","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"3315","DOI":"10.1063\/1.1287273","article-title":"An analytical solution of the stochastic master equation for reversible bimolecular reaction kinetics","volume":"113","author":"Laurenzi","year":"2000","journal-title":"J. Chem. Phys."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"387","DOI":"10.1124\/pr.56.3.3","article-title":"Cyclooxygenase isozymes: The biology of prostaglandin synthesis and inhibition","volume":"56","author":"Simmons","year":"2004","journal-title":"Pharmacol. Rev."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"663","DOI":"10.1016\/j.cell.2006.07.024","article-title":"Induction of pluripotent stem cells from mouse embryonic and adult fibroblast cultures by defined factors","volume":"126","author":"Takahashi","year":"2006","journal-title":"Cell"},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1007\/s10549-005-9048-0","article-title":"Pik3ca mutations in breast cancer are associated with poor outcome","volume":"96","author":"Li","year":"2006","journal-title":"Breast Cancer Res. Treat."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"2050","DOI":"10.1016\/j.yexcr.2007.03.040","article-title":"Novel functions of vimentin in cell adhesion, migration, and signaling","volume":"313","author":"Ivaska","year":"2007","journal-title":"Exp. Cell Res."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"162","DOI":"10.1038\/ncb1824","article-title":"Nuclear signalling by tumour-associated antigen epcam","volume":"11","author":"Maetzel","year":"2009","journal-title":"Nat. Cell Biol."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1186\/1756-9966-29-92","article-title":"Reduced expression of toll-like receptor 4 inhibits human breast cancer cells proliferation and inflammatory cytokines secretion","volume":"29","author":"Yang","year":"2010","journal-title":"J. Exp. Clin. Cancer Res."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1016\/j.canlet.2011.04.002","article-title":"Microrna-519d targets mki67 and suppresses cell growth in the hepatocellular carcinoma cell line qgy-7703","volume":"307","author":"Hou","year":"2011","journal-title":"Cancer Lett."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"1476","DOI":"10.3389\/fimmu.2017.01476","article-title":"Local high-dose radiotherapy induces systemic immunomodulating effects of potential therapeutic relevance in oligometastatic breast cancer","volume":"8","author":"Muraro","year":"2017","journal-title":"Front Immunol."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"961","DOI":"10.1016\/j.omtn.2019.12.031","article-title":"Upregulation of circular rna circatrnl1 to sensitize oral squamous cell carcinoma to irradiation","volume":"19","author":"Chen","year":"2020","journal-title":"Mol. Ther. Nucleic Acids"},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"2467","DOI":"10.1002\/jcb.29469","article-title":"Matrine involves in the progression of gastric cancer through inhibiting mir-93-5p and upregulating the expression of target gene ahnak","volume":"121","author":"Liu","year":"2020","journal-title":"J. cell. Biochem."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1186\/s12964-019-0474-8","article-title":"Bystander effects of ionizing radiation: Conditioned media from x-ray irradiated mcf-7 cells increases the angiogenic ability of endothelial cells","volume":"17","author":"Jabbari","year":"2019","journal-title":"Cell commun. Signal."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1186\/s12943-016-0577-4","article-title":"Induction of metastasis, cancer stem cell phenotype, and oncogenic metabolism in cancer cells by ionizing radiation","volume":"16","author":"Lee","year":"2017","journal-title":"Mol. cancer"},{"key":"ref_72","doi-asserted-by":"crossref","unstructured":"Jarosz-Biej, M., Smolarczyk, R., Cichon, T., and Kulach, N. (2019). Tumor microenvironment as a \"game changer\" in cancer radiotherapy. Int. J. Mol. Sci., 20.","DOI":"10.3390\/ijms20133212"},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1158\/1535-7163.MCT-17-0262","article-title":"Exploiting radiation-induced signaling to increase the susceptibility of resistant cancer cells to targeted drugs: Akt and mtor inhibitors as an example","volume":"17","author":"Eke","year":"2018","journal-title":"Mol. Cancer Ther."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1016\/j.hoc.2018.12.003","article-title":"Radiation therapy and immune modulation","volume":"33","author":"Leeman","year":"2019","journal-title":"Hematol. Oncol. Clin. N. Am."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"1287","DOI":"10.21873\/anticanres.13240","article-title":"The influence of single nucleotide polymorphisms and adjuvant radiotherapy on systemic inflammatory proteins, chemokines and cytokines of patients with breast cancer","volume":"39","author":"Lewin","year":"2019","journal-title":"Anticancer Res."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"716564","DOI":"10.1155\/2012\/716564","article-title":"Expression of toll-like receptors on breast tumors: Taking a toll on tumor microenvironment","volume":"2012","author":"Bhattacharya","year":"2012","journal-title":"Int. J. Breast Cancer"},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"531","DOI":"10.1002\/cncr.10684","article-title":"Overexpression of cyclooxygenase-2 is associated with a poor prognosis in patients with squamous cell carcinoma of the uterine cervix treated with radiation and concurrent chemotherapy","volume":"95","author":"Kim","year":"2002","journal-title":"Cancer"},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"262","DOI":"10.1186\/s13643-017-0660-y","article-title":"Circulating cancer stem cell markers in breast carcinomas: A systematic review protocol","volume":"6","author":"Mansoori","year":"2017","journal-title":"Syst. Rev."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"616","DOI":"10.1002\/jcla.21911","article-title":"Circulating tumor cells and tumor stem cells detection in the peripheral blood mononuclear cells of breast cancer","volume":"30","author":"Wang","year":"2016","journal-title":"J. Clin. Lab. Anal."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"2736","DOI":"10.1016\/j.biocel.2013.09.008","article-title":"Epithelial cell adhesion molecule (epcam) is associated with prostate cancer metastasis and chemo\/radioresistance via the pi3k\/akt\/mtor signaling pathway","volume":"45","author":"Ni","year":"2013","journal-title":"Int. J. Biochem. Cell B"},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1007\/s10549-016-3997-3","article-title":"Impact of apoptotic circulating tumor cells (actc) in metastatic breast cancer","volume":"160","author":"Deutsch","year":"2016","journal-title":"Breast Cancer Res. Treat."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"1692","DOI":"10.3892\/ijo.2013.1845","article-title":"Molecular mechanisms of radiation resistance in doxorubicin-resistant breast adenocarcinoma cells","volume":"42","author":"Luzhna","year":"2013","journal-title":"Int. J. Oncol."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"e43","DOI":"10.1016\/S1470-2045(11)70191-7","article-title":"Breast-cancer stem cells-beyond semantics","volume":"13","author":"Badve","year":"2012","journal-title":"Lancet Oncol."},{"key":"ref_84","doi-asserted-by":"crossref","unstructured":"Olivares-Urbano, M.A., Grinan-Lison, C., Rios-Arrabal, S., Artacho-Cordon, F., Torralbo, A.I., Lopez-Ruiz, E., Marchal, J.A., and Nunez, M.I. (2019). Radiation and stemness phenotype may influence individual breast cancer outcomes: The crucial role of mmps and microenvironment. Cancers, 11.","DOI":"10.3390\/cancers11111781"},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"298","DOI":"10.1093\/jrr\/rrz011","article-title":"Analysis of the high-dose-range radioresistance of prostate cancer cells, including cancer stem cells, based on a stochastic model","volume":"60","author":"Saga","year":"2019","journal-title":"J. Radiat. Res."},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"455","DOI":"10.1016\/j.radonc.2017.08.019","article-title":"Radioresistance of the breast tumor is highly correlated to its level of cancer stem cell and its clinical implication for breast irradiation","volume":"124","author":"Qi","year":"2017","journal-title":"Radiother. Oncol."},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"101009","DOI":"10.1016\/j.tranon.2021.101009","article-title":"Influence of adjuvant radiotherapy on circulating epithelial tumor cells and circulating cancer stem cells in primary non-metastatic breast cancer","volume":"14","author":"Schott","year":"2021","journal-title":"Transl. Oncol."},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"6632","DOI":"10.1158\/0008-5472.CAN-18-0650","article-title":"Circulating glioma cells exhibit stem cell-like properties","volume":"78","author":"Liu","year":"2018","journal-title":"Cancer Res."},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1111\/j.1600-0897.2009.00803.x","article-title":"Rcas1, mt, and vimentin as potential markers of tumor microenvironment remodeling","volume":"63","year":"2010","journal-title":"Am. J. Reprod. Immunol."},{"key":"ref_90","doi-asserted-by":"crossref","unstructured":"Pachmann, K., and Schuster, S. (2018). The value of monitoring the behavior of circulating tumor cells at the end of endocrine therapy in breast cancer patients. Cancers, 10.","DOI":"10.3390\/cancers10110407"},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1016\/j.ctrv.2011.04.002","article-title":"Epithelial cell adhesion molecule expression (cd326) in cancer: A short review","volume":"38","author":"Patriarca","year":"2012","journal-title":"Cancer Treat. Rev."}],"container-title":["Current Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1718-7729\/28\/5\/302\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T06:58:38Z","timestamp":1760165918000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1718-7729\/28\/5\/302"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,9,8]]},"references-count":91,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2021,10]]}},"alternative-id":["curroncol28050302"],"URL":"https:\/\/doi.org\/10.3390\/curroncol28050302","relation":{},"ISSN":["1718-7729"],"issn-type":[{"value":"1718-7729","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,9,8]]}}}