Scheme 1.

Schematic illustration of nano-bio therapeutic emulsion formulated with nanoscintillators, anaerobic C. novyi-NT spores, and ethiodized oil for the synergistic combination of X-ray photodynamic and anaerobic bacteriolytic therapy. In this system, RB-NSs that generate reactive oxygen species (ROS) through fluorescence resonance energy transfer (FRET) upon X-ray irradiation and oncolytic anaerobic bacterial spores (C. novyi-NT spores) form a nano-bio therapeutic emulsion with ethiodized oil (EO). Image-guided infused nano-bio therapeutic emulsion allowing a synergistic combination of X-ray PDT (ROS) and anaerobic bacterial cancer therapy effectively treats both normoxic peripheral tumor and central hypoxic tumor,