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Titanium peroxide nanoparticles (TiOxNPs) are an experimental class of radiosensitizing agents developed to overcome radioresistance in solid tumors, particularly pancreatic cancer. These nanoparticles are typically synthesized from titanium dioxide and can be surface-modified with polyacrylic acid (PAA) to enhance biocompatibility and stability in vivo. The primary mechanism of action involves the catalytic generation of high levels of reactive oxygen species (ROS), including hydroxyl radicals and hydrogen peroxide, when triggered by ionizing radiation (X-rays). This localized oxidative stress induces significant DNA damage and inhibits the AKT signaling pathway, which is crucial for the survival and self-renewal of cancer stem cells (CSCs). Preclinical studies have demonstrated that TiOxNPs can effectively eliminate radioresistant pancreatic CSCs, suppress epithelial-mesenchymal transition (EMT), and inhibit tumor growth in xenograft models with minimal systemic toxicity. Furthermore, TiOxNPs have shown potential as contrast agents for image-guided radiation therapy (IGRT) due to their detectable signal in cone-beam computed tomography (CBCT).
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