Sonodynamic Therapy and Sonosensitizers for Glioma Treatment: A Systematic Qualitative Review

Sonodynamic therapy (SDT) has emerged as an encouraging noninvasive technique that uses ultrasound to activate targeted agents to induce antitumor effects for the treatment of glioma. With extensive variation in the types of sonosensitizers, protocols for sonication, and model systems, a comprehensive overview of existing preclinical data on the efficacy of SDT in glioma treatment is warranted. Here, we conduct a systematic review of preclinical and early clinical literature on implementing SDT to treat in vitro and in vivo models of glioma. Our findings suggest that coupling sonosensitizers such as 5aminolevulinic acid, hematoporphyrin monomethyl ether, and sinoporphyrin sodium with focused ultrasound induces robust cytotoxic activity in tumor cells (in vitro and in vivo). These effects are likely mediated by the oxidative stress induced by reactive oxygen species production, apoptotic signaling cascades, and intracellular calcium overload. Future research is needed to better understand the biochemical and mechanistic properties of SDT, and ongoing trials may help elucidate the clinical feasibility of glioma treatment with optimized sonically activated treatments.

Automated summary

Sonodynamic therapy (SDT) is a promising noninvasive technique that uses ultrasound to activate targeted agents for glioma treatment. The comprehensive overview of preclinical data on SDT efficacy is needed, considering the variations in sonosensitizers, sonication protocols, and model systems. Coupling sonosensitizers with focused ultrasound induces cytotoxic activity in tumor cells through oxidative stress, apoptotic signaling, and intracellular calcium overload. Further research and ongoing trials are necessary to understand the biochemical and mechanistic properties of SDT and evaluate its clinical feasibility for glioma treatment.