Seminars in Radiation Oncology最新文献_第4页

Unraveling the Myth of Radiation Resistance in Soft Tissue Sarcomas 揭开软组织肉瘤的抗辐射神话

IF 3.5 3区医学

Seminars in Radiation Oncology Pub Date : 2024-03-18 DOI: 10.1016/j.semradonc.2023.12.004

LM Wiltink MD, PhD , AB Miah MD, PhD , AN Scholten MD, PhD , RL Haas MD, PhD

{"title":"Unraveling the Myth of Radiation Resistance in Soft Tissue Sarcomas","authors":"LM Wiltink MD, PhD , AB Miah MD, PhD , AN Scholten MD, PhD , RL Haas MD, PhD","doi":"10.1016/j.semradonc.2023.12.004","DOIUrl":"https://doi.org/10.1016/j.semradonc.2023.12.004","url":null,"abstract":"<div><p><span><span>There is a misconception that sarcomas are resistant to </span>radiotherapy<span>. This manuscript summarizes available (pre-) clinical data on the radiosensitivity<span> of soft tissue sarcomas<span><span>. Currently, clinical practice guidelines suggest irradiating sarcomas in 1.8-2 Gy once daily fractions. Careful observation of myxoid liposarcomas patients during </span>preoperative radiotherapy led to the discovery of this subtype's remarkable radiosensitivity. It resulted subsequently in an international prospective </span></span></span></span>clinical trial<span><span> demonstrating the safety of a reduced total dose, yet still delivered with conventional 1.8-2 Gy fractions. In several areas of oncology, especially for tumors of epithelial origin where radiotherapy plays a curative role, the concurrent application of systemic compounds aiming for </span>radiosensitization has been incorporated into routine clinical practice. This approach has also been investigated in sarcomas and is summarized in this manuscript. Observing relatively low α/β ratios after preclinical cellular investigations, investigators have explored hypofractionation with daily doses ranging from 2.85-8.0 Gy per day in prospective clinical studies, and the data are presented. Finally, we summarize work with mouse models and genomic investigations to predict observed responses to radiotherapy in sarcoma patients. Taken together, these data indicate that sarcomas are not resistant to radiation therapy.</span></p></div>","PeriodicalId":49542,"journal":{"name":"Seminars in Radiation Oncology","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140160573","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

The Role of Radiotherapy in the Contemporary Management of Patients With Sarcoma: Opportunities to Improve Patient Outcomes 放疗在当代肉瘤患者治疗中的作用：提高患者疗效的机会

IF 3.5 3区医学

Seminars in Radiation Oncology Pub Date : 2024-03-18 DOI: 10.1016/j.semradonc.2024.02.004

David G. Kirsch

引用次数: 0

Progress in Retroperitoneal Sarcoma Management: Surgical and Radiotherapy Approaches 腹膜后肉瘤治疗的进展：手术和放疗方法

IF 3.5 3区医学

Seminars in Radiation Oncology Pub Date : 2024-03-18 DOI: 10.1016/j.semradonc.2024.02.002

Hiba Othman , Joel Shapiro , Peter Chung , Rebecca A. Gladdy

{"title":"Progress in Retroperitoneal Sarcoma Management: Surgical and Radiotherapy Approaches","authors":"Hiba Othman , Joel Shapiro , Peter Chung , Rebecca A. Gladdy","doi":"10.1016/j.semradonc.2024.02.002","DOIUrl":"https://doi.org/10.1016/j.semradonc.2024.02.002","url":null,"abstract":"<div><p>Surgical resection is the cornerstone of curative treatment for retroperitoneal sarcomas (RPS), aiming for complete excision, yet the complexity of RPS with its proximity to vital structures continues to lead to high local recurrence rates after surgery alone. Thus, the role of radiotherapy (RT) continues to be refined to improve local control, which remains an important goal to prevent RPS recurrence. The recently completed global randomized trial to evaluate the role of surgery with and without preoperative RT – STRASS1, did not demonstrate a significant overall benefit for neoadjuvant RT based on the pre-specified definition of abdominal recurrence-free survival, however, sensitivity analysis using a standard definition of local recurrence and analysis of outcomes by compliance to the RT protocol suggests histology-specific benefit in well- and some de-differentiated liposarcomas. Ultimately, multidisciplinary collaboration and personalized approaches that consider histological sarcoma types and patient-specific factors are imperative for optimizing the therapeutic strategy in the management of RPS.</p></div>","PeriodicalId":49542,"journal":{"name":"Seminars in Radiation Oncology","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1053429624000031/pdfft?md5=6db0653db9f0e408b8f9dfb4e27ddfcf&pid=1-s2.0-S1053429624000031-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140160574","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The Use of Proton and Carbon Ion Radiation Therapy for Sarcomas 使用质子和碳离子放射治疗肉瘤

IF 3.5 3区医学

Seminars in Radiation Oncology Pub Date : 2024-03-18 DOI: 10.1016/j.semradonc.2024.02.003

Myrsini Ioakeim-Ioannidou , Melanie Rose , Yen-Lin Chen , Shannon M. MacDonald

引用次数: 0

Opportunity in Complexity: Harnessing Molecular Biomarkers and Liquid Biopsies for Personalized Sarcoma Care 复杂中的机遇：利用分子生物标记物和液体活检实现个性化肉瘤治疗

IF 3.5 3区医学

Seminars in Radiation Oncology Pub Date : 2024-03-18 DOI: 10.1016/j.semradonc.2023.12.002

Agnes Ewongwo , Caressa Hui , Everett J. Moding

引用次数: 0

Immunotherapy and Radiotherapy Combinations for Sarcoma 肉瘤的免疫疗法和放疗联合疗法

IF 3.5 3区医学

Seminars in Radiation Oncology Pub Date : 2024-03-18 DOI: 10.1016/j.semradonc.2023.12.005

Qian S. Zhang , John P. Hayes , Vinai Gondi , Seth M. Pollack

{"title":"Immunotherapy and Radiotherapy Combinations for Sarcoma","authors":"Qian S. Zhang , John P. Hayes , Vinai Gondi , Seth M. Pollack","doi":"10.1016/j.semradonc.2023.12.005","DOIUrl":"https://doi.org/10.1016/j.semradonc.2023.12.005","url":null,"abstract":"<div><p><span><span>Sarcomas are a heterogeneous group of bone and soft tissue tumors. Survival outcomes for advanced (unresectable or metastatic) disease remain poor, so therapeutic improvements are needed. </span>Radiotherapy<span><span> plays an integral role in the neoadjuvant and adjuvant treatment of localized disease as well as in the treatment of </span>metastatic disease<span>. Combining radiotherapy with immunotherapy<span> to potentiate immunotherapy has been used in a variety of cancers other than sarcoma, and there is opportunity to further investigate combining immunotherapy with radiotherapy to try to improve outcomes in sarcoma. In this review, we describe the diversity of the tumor immune microenvironments for sarcomas and describe the immunomodulatory effects of radiotherapy. We discuss studies on the timing of radiotherapy relative to immunotherapy and studies on the radiotherapy dose and fractionation regimen to be used in combination with immunotherapy. We describe the impact of radiotherapy on the tumor immune microenvironment. We review completed and ongoing </span></span></span></span>clinical trials combining radiotherapy with immunotherapy for sarcoma and propose future directions for studies combining immunotherapy with radiotherapy in the treatment of sarcoma.</p></div>","PeriodicalId":49542,"journal":{"name":"Seminars in Radiation Oncology","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140160580","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

FLASH Radiotherapy: What Can FLASH's Ultra High Dose Rate Offer to the Treatment of Patients With Sarcoma? FLASH 放射治疗：FLASH 的超高剂量率能为肉瘤患者的治疗带来什么？

IF 3.5 3区医学

Seminars in Radiation Oncology Pub Date : 2024-03-18 DOI: 10.1016/j.semradonc.2024.02.001

Keith A. Cengel, Michele M. Kim, Eric S. Diffenderfer, Theresa M. Busch

{"title":"FLASH Radiotherapy: What Can FLASH's Ultra High Dose Rate Offer to the Treatment of Patients With Sarcoma?","authors":"Keith A. Cengel, Michele M. Kim, Eric S. Diffenderfer, Theresa M. Busch","doi":"10.1016/j.semradonc.2024.02.001","DOIUrl":"https://doi.org/10.1016/j.semradonc.2024.02.001","url":null,"abstract":"<div><p>FLASH is an emerging treatment paradigm in radiotherapy (RT) that utilizes ultra-high dose rates (UHDR; >40 Gy)/s) of radiation delivery. Developing advances in technology support the delivery of UHDR using electron and proton systems, as well as some ion beam units (eg, carbon ions), while methods to achieve UHDR with photons are under investigation. The major advantage of FLASH RT is its ability to increase the therapeutic index for RT by shifting the dose response curve for normal tissue toxicity to higher doses. Numerous preclinical studies have been conducted to date on FLASH RT for murine sarcomas, alongside the investigation of its effects on relevant normal tissues of skin, muscle, and bone. The tumor control achieved by FLASH RT of sarcoma models is indistinguishable from that attained by treatment with standard RT to the same total dose. FLASH's high dose rates are able to mitigate the severity or incidence of RT side effects on normal tissues as evaluated by endpoints ranging from functional sparing to histological damage. Large animal studies and clinical trials of canine patients show evidence of skin sparing by FLASH vs. standard RT, but also caution against delivery of high single doses with FLASH that exceed those safely applied with standard RT. Also, a human clinical trial has shown that FLASH RT can be delivered safely to bone metastasis. Thus, data to date support continued investigations of clinical translation of FLASH RT for the treatment of patients with sarcoma. Toward this purpose, hypofractionated irradiation schemes are being investigated for FLASH effects on sarcoma and relevant normal tissues.</p></div>","PeriodicalId":49542,"journal":{"name":"Seminars in Radiation Oncology","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140160579","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

MRI-Guided Adaptive Radiation Therapy 磁共振成像引导的自适应放射治疗

IF 3.5 3区医学

Seminars in Radiation Oncology Pub Date : 2023-12-15 DOI: 10.1016/j.semradonc.2023.10.013

Cecil M. Benitez , Michael D. Chuong , Luise A. Künzel , Daniela Thorwarth

引用次数: 0

The Use of MR-Guided Radiation Therapy for Liver Cancer 使用磁共振引导的放射治疗肝癌

IF 3.5 3区医学

Seminars in Radiation Oncology Pub Date : 2023-12-15 DOI: 10.1016/j.semradonc.2023.10.006

Sabrina Prime , Joshua P. Schiff , Ali Hosni , Teodor Stanescu , Laura A. Dawson , Lauren E. Henke

引用次数: 0

Rectal Cancer MRI Guided Radiotherapy: A Practical Review for the Physician 直肠癌核磁共振引导放疗：医生实用评论

IF 3.5 3区医学

Seminars in Radiation Oncology Pub Date : 2023-12-15 DOI: 10.1016/j.semradonc.2023.10.004

Giuditta Chiloiro , Cihan Gani , Luca Boldrini

引用次数: 0