Seminars in Radiation Oncology最新文献_第10页

Brain Metastases: Is There Still a Role for Whole-Brain Radiation Therapy? 脑转移瘤:全脑放射治疗是否仍有作用?

IF 3.5 3区医学

Seminars in Radiation Oncology Pub Date : 2023-04-01 DOI: 10.1016/j.semradonc.2023.01.005

Carsten Nieder MD , Nicolaus H. Andratschke MD , Anca L. Grosu MD

{"title":"Brain Metastases: Is There Still a Role for Whole-Brain Radiation Therapy?","authors":"Carsten Nieder MD , Nicolaus H. Andratschke MD , Anca L. Grosu MD","doi":"10.1016/j.semradonc.2023.01.005","DOIUrl":"10.1016/j.semradonc.2023.01.005","url":null,"abstract":"<div>Whole-brain radiation therapy (WBRT) has commonly been prescribed to palliate symptoms from brain metastases, to reduce the risk of local relapse after surgical resection, and to improve distant brain control after resection or radiosurgery. While targeting micrometastases throughout the brain can be considered advantageous, the simultaneous exposure of healthy brain tissue might cause adverse events. Attempts to mitigate the risk of neurocognitive decline after WBRT include the selective avoidance of the hippocampi, among others. Besides selective dose reduction, dose escalation to boost volumes, for example, simultaneous integrated boost, aiming at increased tumor control probability is technically feasible. While up-front radiotherapy for newly diagnosed brain metastases often employs radiosurgery or other techniques targeting visible lesions only, sequential (delayed) salvage treatment with WBRT might still become necessary. In addition, the presence of leptomeningeal tumors or very widespread parenchymatous brain metastases might prompt clinicians to prescribe early WBRT.</div>","PeriodicalId":49542,"journal":{"name":"Seminars in Radiation Oncology","volume":"33 2","pages":"Pages 129-138"},"PeriodicalIF":3.5,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9282558","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 2

The Role of Stereotactic Body Radiation Therapy in the Management of Liver Metastases 立体定向放射治疗在肝转移瘤治疗中的作用

IF 3.5 3区医学

Seminars in Radiation Oncology Pub Date : 2023-04-01 DOI: 10.1016/j.semradonc.2022.11.008

Sangjune Laurence Lee , Michael F. Bassetti , Chad G. Rusthoven

{"title":"The Role of Stereotactic Body Radiation Therapy in the Management of Liver Metastases","authors":"Sangjune Laurence Lee , Michael F. Bassetti , Chad G. Rusthoven","doi":"10.1016/j.semradonc.2022.11.008","DOIUrl":"10.1016/j.semradonc.2022.11.008","url":null,"abstract":"<div>The liver is a common site for metastatic spread for various primary tumor histologies. Stereotactic body radiation therapy (SBRT) is a non-invasive treatment technique with broad patient candidacy for the ablation of tumors in the liver and other organs. SBRT involves focused, high-dose radiation therapy delivered in one to several treatments, resulting in high rates of local control. Use of SBRT for ablation of oligometastatic disease has increased in recent years and emerging prospective data have demonstrated improvements in progression free and overall survival in some settings. When delivering SBRT to liver metastases, clinicians must balance the priorities of delivering ablative tumor dosing while respecting dose constraints to surrounding organs at risk (OARs). Motion management techniques are crucial for meeting dose constraints, ensuring low rates of toxicity, maintaining quality of life, and can allow for dose escalation. Advanced radiotherapy delivery approaches including proton therapy, robotic radiotherapy, and real-time MR-guided radiotherapy may further improve the accuracy of liver SBRT. In this article, we review the rationale for oligometastases ablation, the clinical outcomes with liver SBRT, tumor dose and OAR considerations, and evolving strategies to improve liver SBRT delivery.</div>","PeriodicalId":49542,"journal":{"name":"Seminars in Radiation Oncology","volume":"33 2","pages":"Pages 181-192"},"PeriodicalIF":3.5,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9287150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Radiation Therapy for Painful Bone Metastases: Fractionation, Recalcification, and Symptom Control 疼痛骨转移的放射治疗:分级、钙化和症状控制

IF 3.5 3区医学

Seminars in Radiation Oncology Pub Date : 2023-04-01 DOI: 10.1016/j.semradonc.2022.11.004

Yolanda D. Tseng MD, MPhil

{"title":"Radiation Therapy for Painful Bone Metastases: Fractionation, Recalcification, and Symptom Control","authors":"Yolanda D. Tseng MD, MPhil","doi":"10.1016/j.semradonc.2022.11.004","DOIUrl":"10.1016/j.semradonc.2022.11.004","url":null,"abstract":"<div>Bone is a common site for metastases, which may cause pain and other skeletal-related events (SRE) in patients with advanced cancer. Since the 1980s, prospective clinical trials have demonstrated the high efficacy of external beam radiotherapy (EBRT) for pain relief from focal, symptomatic lesions. In uncomplicated bone metastases, which include those without pathologic fracture, evidence of cord compression, or prior surgical intervention, improvement or complete pain relief with radiotherapy is as high as 60%, with no difference in efficacy when radiotherapy is delivered in a single or multiple fractions. The ability to treat with a single fraction makes EBRT an attractive therapy even for patients with poor performance status and/or life expectancy. Even in patients with complicated bone metastases (eg cord compression), several randomized trials have demonstrated similar rates of pain relief in addition to improved functional outcomes such as ambulation. In this review, we summarize the role of EBRT for alleviating painful bone metastases and explore its role for other endpoints including functional outcomes, recalcification, and prevention of SREs.</div>","PeriodicalId":49542,"journal":{"name":"Seminars in Radiation Oncology","volume":"33 2","pages":"Pages 139-147"},"PeriodicalIF":3.5,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9282559","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Precision Radiation for Brain Metastases With a Focus on Hypofractionated Stereotactic Radiosurgery 精确放射治疗脑转移瘤，重点是低分割立体定向放射手术

IF 3.5 3区医学

Seminars in Radiation Oncology Pub Date : 2023-04-01 DOI: 10.1016/j.semradonc.2023.01.004

Kevin Shiue , Arjun Sahgal , Simon S. Lo

{"title":"Precision Radiation for Brain Metastases With a Focus on Hypofractionated Stereotactic Radiosurgery","authors":"Kevin Shiue , Arjun Sahgal , Simon S. Lo","doi":"10.1016/j.semradonc.2023.01.004","DOIUrl":"10.1016/j.semradonc.2023.01.004","url":null,"abstract":"<div>There are multiple published randomized controlled trials supporting single-fraction stereotactic radiosurgery (SF-SRS) for patients presenting with 1 to 4 brain metastases, with the benefit of minimizing radiation-induced neurocognitive sequelae as compared to whole brain radiotherapy . More recently, the dogma of SF-SRS as the only means of delivering an SRS treatment has been challenged by hypofractionated SRS (HF-SRS). The ability to deliver 25-35 Gy in 3-5 HF-SRS fractions is a direct consequence of the evolution of radiation technologies to allow image guidance, specialized treatment planning, robotic delivery and/or patient positioning corrections in all 6 degrees-of-freedom, and frameless head immobilization. The intent is to mitigate the potentially devastating complication of radiation necrosis and improve rates of local control for larger metastases. This narrative review provides an overview of outcomes specific to HF-SRS in addition to the more recent developments of staged SRS, preoperative SRS, and hippocampal avoidance-whole brain radiotherapy with simultaneous integrated boost.</div>","PeriodicalId":49542,"journal":{"name":"Seminars in Radiation Oncology","volume":"33 2","pages":"Pages 114-128"},"PeriodicalIF":3.5,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9282557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Palliative Care Delivery Systems and Integration With Palliative Care Teams 姑息治疗提供系统和与姑息治疗团队的整合

IF 3.5 3区医学

Seminars in Radiation Oncology Pub Date : 2023-04-01 DOI: 10.1016/j.semradonc.2022.11.003

Michelle Iocolano , Alyssa Langi , Kavita V. Dharmarajan , Joshua Jones

引用次数: 1

Radiation Therapy in the Management of Adrenal Metastases 放射治疗在肾上腺转移瘤治疗中的应用

IF 3.5 3区医学

Seminars in Radiation Oncology Pub Date : 2023-04-01 DOI: 10.1016/j.semradonc.2022.11.001

Ciro Franzese MD , Sara Stefanini , Marta Scorsetti

引用次数: 0

Pharmacologic Pain Management: What Radiation Oncologists Should Know 药理学疼痛管理:放射肿瘤学家应该知道的

IF 3.5 3区医学

Seminars in Radiation Oncology Pub Date : 2023-04-01 DOI: 10.1016/j.semradonc.2023.01.002

Lara Michal Skarf , Katie Fitzgerald Jones , Jordana L. Meyerson , Janet L. Abrahm

引用次数: 0

Radiotherapy for Lung Metastases: Conventional to Stereotactic Body Radiation Therapy 肺转移瘤的放射治疗：常规到立体定向身体放射治疗

IF 3.5 3区医学

Seminars in Radiation Oncology Pub Date : 2023-04-01 DOI: 10.1016/j.semradonc.2022.11.007

Avipsa Das , Meredith Giuliani , Andrea Bezjak

引用次数: 0

Personalization of Radiation Therapy in the Primary Treatment of Malignant Epidural Spinal Cord Compression (MESCC) 恶性硬膜外脊髓压迫(MESCC)的个体化放射治疗

IF 3.5 3区医学

Seminars in Radiation Oncology Pub Date : 2023-04-01 DOI: 10.1016/j.semradonc.2022.11.005

Dirk Rades , Steven E. Schild

{"title":"Personalization of Radiation Therapy in the Primary Treatment of Malignant Epidural Spinal Cord Compression (MESCC)","authors":"Dirk Rades , Steven E. Schild","doi":"10.1016/j.semradonc.2022.11.005","DOIUrl":"10.1016/j.semradonc.2022.11.005","url":null,"abstract":"<div>“True” malignant epidural spinal cord compression (MESCC) is used here to describe a lesion compressing of infiltrating the spinal cord associated with neurologic deficits. Radiotherapy alone is the most common treatment, for which several dose-fractionation regimens are available including single-fraction, short-course and longer-course regimens. Since these regimens are similarly effective regarding functional outcomes, patients with poor survival are optimally treated with short-course or even single-fraction radiotherapy. Longer-course radiotherapy results in better local control of malignant epidural spinal cord compression. Since most in-field recurrences occur 6 months or later, local control is particularly important for longer-term survivors who, therefore, should receive longer-course radiotherapy. It is important to estimate survival prior to treatment, which is facilitated by scoring tools. Radiotherapy should be supplemented by corticosteroids, if safely possible. Bisphosphonates and RANK-ligand inhibitors may improve local control. Selected patients can benefit from upfront decompressive surgery. Identification of these patients is facilitated by prognostic instruments considering degree of compression, myelopathy, radio-sensitivity, spinal stability, post-treatment ambulatory status, and patients’ performance status and survival prognoses. Many factors including patients’ preferences must be considered when designing personalized treatment regimens.</div>","PeriodicalId":49542,"journal":{"name":"Seminars in Radiation Oncology","volume":"33 2","pages":"Pages 148-158"},"PeriodicalIF":3.5,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9287573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Stereotactic Body Radiation Therapy for Spinal Metastases: Benefits and Limitations 立体定向放射治疗脊柱转移:益处和局限性

IF 3.5 3区医学

Seminars in Radiation Oncology Pub Date : 2023-04-01 DOI: 10.1016/j.semradonc.2022.11.006

Matthias Guckenberger MD , Max Dahele MBChB, PhD , Wee Loon Ong MBBS , Arjun Sahgal MD

引用次数: 4