Abstract
Bladder cancer (BCa) is the most common cancer of the human urinary system, and is associated with poor patient prognosis and a high recurrence rate. Cancer stem cells (CSCs) are the primary cause of tumor recurrence and metastasis, possessing self‑renewal properties and resistance to radiation therapy. Our previous studies indicated that phosphorylated signal transduction and transcription activator 3 (STAT3) may be a potential biomarker to predict radiation tolerance and tumor recurrence in patients with BCa, following conventional radiotherapy. The aim of the present study was to investigate the underlying mechanism of STAT3 in the radio‑resistance of BCa cells. It was found that fractionated irradiation promoted the activation of two STAT3‑associated CSCs signaling pathways in BCa cells, namely suppressor of variegation 3‑9 homolog 1/GATA binding protein 3/STAT3 and Janus kinase 2/STAT3. Surviving cells exhibited elevated migratory and invasive abilities, enhanced CSC‑like characteristics and radio‑resistance. Furthermore, knockdown of STAT3 expression or inhibition of STAT3 activation markedly decreased the self‑renewal ability and tumorigenicity of radiation‑resistant BCa cells. Kaplan‑Meier analysis revealed that decreased STAT3 mRNA levels were associated with increased overall survival times in patients with BCa. Taken together, these data indicated that STAT3 may be an effective therapeutic target for inhibiting the progression, metastasis and recurrence of BCa in patients receiving radiotherapy.