Journal of the National Cancer Center最新文献

{"title":"Dynamic toxicity landscape of immunotherapy for solid tumors across treatment lines","authors":"Lihui Liu ,&nbsp;Sini Li ,&nbsp;Guoqiang Wang ,&nbsp;Yan Qu ,&nbsp;Zhijie Wang ,&nbsp;Jianchun Duan ,&nbsp;Chao Wang ,&nbsp;Pei Xue ,&nbsp;Xue Zhang ,&nbsp;Zixiao Ma ,&nbsp;Hua Bai ,&nbsp;Jie Wang","doi":"10.1016/j.jncc.2023.07.002","DOIUrl":"10.1016/j.jncc.2023.07.002","url":null,"abstract":"<div><h3>Objective</h3><p>Immune checkpoint inhibitors (ICIs) targeting programmed cell death-1/ligand-1 (PD-1/PD-L1), cytotoxic T lymphocyte antigen-4 (CTLA-4), and lymphocyte-activation gene-3 (LAG-3) have been widely studied and applied throughout the course of cancer treatment. This study aimed to provide a comprehensive profile of ICI-associated toxicity and elucidate the toxicity patterns of ICIs across different treatment lines.</p></div><div><h3>Methods</h3><p>In total, 155 cohorts comprising 24 539 eligible patients were included in the safety analysis. Trial name, registration number, cancer type, trial phase, clinical setting, trial design, regimen, dosing schedule, age, sex and ethnicity distributions, number of patients, number of treatment-related adverse events (trAEs), and number of treatment-related death were extracted. We defined a timeline from the neoadjuvant setting to the third-line setting. We also introduced a synthesizing principle for adverse event rates (SPAER) of immunotherapy to ensure the comparability and reliability across different treatment lines. The study protocol was registered and approved by the PROSPERO protocol review committee (CRD42021242368).</p></div><div><h3>Results</h3><p>After excluding the neoadjuvant setting group, we observed a distinct reduction in the incidence of treatment-related adverse events (trAEs) with an advancement of the line of ICI treatment. The incidence of trAEs was negatively correlated with the line of treatment, irrespective of whether monotherapy or dual-ICI combination therapy was administered. Sensitivity analyses also confirmed the coincident negative correlations.</p></div><div><h3>Conclusion</h3><p>In summary, using a timeline-based concept centered around treatment lines, we revealed the dynamic landscape of ICI-associated toxicity and found that patients treated with ICIs during later lines of therapy may have a lower risk of trAEs.</p></div>","PeriodicalId":73987,"journal":{"name":"Journal of the National Cancer Center","volume":"3 3","pages":"Pages 186-196"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46569741","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An overview of artificial intelligence in medical physics and radiation oncology","authors":"Jiali Liu ,&nbsp;Haonan Xiao ,&nbsp;Jiawei Fan ,&nbsp;Weigang Hu ,&nbsp;Yong Yang ,&nbsp;Peng Dong ,&nbsp;Lei Xing ,&nbsp;Jing Cai","doi":"10.1016/j.jncc.2023.08.002","DOIUrl":"10.1016/j.jncc.2023.08.002","url":null,"abstract":"<div><p>Artificial intelligence (AI) is developing rapidly and has found widespread applications in medicine, especially radiotherapy. This paper provides a brief overview of AI applications in radiotherapy, and highlights the research directions of AI that can potentially make significant impacts and relevant ongoing research works in these directions. Challenging issues related to the clinical applications of AI, such as robustness and interpretability of AI models, are also discussed. The future research directions of AI in the field of medical physics and radiotherapy are highlighted.</p></div>","PeriodicalId":73987,"journal":{"name":"Journal of the National Cancer Center","volume":"3 3","pages":"Pages 211-221"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42791235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The potential role of minimal/molecular residual disease in colorectal cancer: curative surgery, radiotherapy and beyond","authors":"Meiyi Xu ,&nbsp;Tianhao Shi ,&nbsp;Ruilian Xu ,&nbsp;Gong Chen ,&nbsp;Wan He","doi":"10.1016/j.jncc.2023.05.005","DOIUrl":"10.1016/j.jncc.2023.05.005","url":null,"abstract":"<div><p>Detection of minimal/molecular residual disease (MRD) based on ctDNA assay develops from hematological malignancies to solid tumors. Generally, there are two mainstream assays in MRD testing technology: tumor-informed and tumor-agnostic. For colorectal cancer (CRC), MRD is used not only to monitor recurrence and predict prognosis, but also to help in clinical decision making and assessment of clinical efficacy in the settings of curative surgery, radiotherapy, chemotherapy and surveillance. Accumulated clinical trials are exploring roles of MRD in early or advanced stages of CRC. Here, we give an overview of how MRD is and will be used in CRC.</p></div>","PeriodicalId":73987,"journal":{"name":"Journal of the National Cancer Center","volume":"3 3","pages":"Pages 203-210"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45848960","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility and long-term outcomes of post-chemotherapy-based consolidation radiotherapy in extensive stage small-cell lung cancer","authors":"Chen Jie ,&nbsp;Yeshan Chen ,&nbsp;Yong Yang ,&nbsp;Rumeng Li ,&nbsp;Bin Yang ,&nbsp;Connie Yip ,&nbsp;Jing Yu","doi":"10.1016/j.jncc.2023.07.003","DOIUrl":"10.1016/j.jncc.2023.07.003","url":null,"abstract":"<div><h3>Background</h3><p>The target definition of consolidation radiotherapy (RT) for extensive stage small-cell lung cancer (ES-SCLC) has not been standardized. This study aimed to demonstrate the feasibility of post-chemotherapy based consolidation RT in ES-SCLC.</p></div><div><h3>Methods</h3><p>All ES-SCLC patients without initial brain metastases who completed ≥ 4 cycles of systemic therapy at Department of Radiation and Medical Oncology, Zhongnan Hospital of Wuhan University from 2012 to 2021 were included in this retrospective study. We correlated the site of first recurrence to the post-chemotherapy-based radiation volume (small-field). Relapse pattern, progression-free survival (PFS) and overall survival (OS) were compared between those received and did not receive consolidation RT.</p></div><div><h3>Results</h3><p>A total of 152 patients were followed up for a median of 31.7 months (interquartile range [IQR], 23.9–39.6 months). The median PFS and OS of the cohort were 8.3 months (IQR, 6.1–11.2 months) and 16.2 months (IQR, 9.9–24.9 months), respectively. Thoracic consolidation RT served not only as an independent prognostic factor for improved PFS in the entire cohort, but also significantly prolonged OS in the subgroup without synchronous liver metastases. Small-field consolidation RT markedly reduced in-field recurrences (hazard ratio [HR], 0.28 [95% CI, 0.12–0.38]; <em>P</em> &lt; 0.001) without increasing out-of-field recurrences (HR, 0.40 [95% CI, 0.13–1.16]; <em>P =</em> 0.080). No relapse was observed at the margin of the targets. Treatment-related toxicities were moderate, with grade 3 acute radiation pneumonia, radiation esophagitis, and bone marrow suppression rates of 8.3%, 3.1%, and 12.5%, respectively. No grade 5 toxicity occurred.</p></div><div><h3>Conclusion</h3><p>Small-field consolidation RT based on post-chemotherapy volume is safe and can significantly improve local control in ES-SCLC.</p></div>","PeriodicalId":73987,"journal":{"name":"Journal of the National Cancer Center","volume":"3 3","pages":"Pages 161-166"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47476678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quality control indices for standardized diagnosis and treatment of esophageal cancer in China (2022 edition)","authors":"Ruixiang Zhang ,&nbsp;Zhen Wang ,&nbsp;Xiaozheng Kang ,&nbsp;Xin Wang ,&nbsp;Bo Zhang ,&nbsp;Hoi-loi Ng ,&nbsp;Liyan Xue ,&nbsp;Wenjing Yang ,&nbsp;Liming Shi ,&nbsp;Hui Wang ,&nbsp;Lvhua Wang ,&nbsp;Yin Li ,&nbsp;Esophageal Cancer Quality Control Expert Committee of the National Cancer Center","doi":"10.1016/j.jncc.2023.07.005","DOIUrl":"10.1016/j.jncc.2023.07.005","url":null,"abstract":"<div><p>Esophageal cancer (EC) is particularly common in China. With the continuing progress of multi-disciplinary therapy including early screening, minimally invasive techniques, radiotherapy and chemotherapy, the 5-year survival of EC has been improved in China. However, there are considerable disparities in the diagnosis and treatment quality among different regions. The Esophageal Cancer Expert Committee of the National Cancer Quality Control Center (NCQCC) considers a set of authoritative quality control standards as an opportunity to eliminate the disparities and improve the overall survival and quality of life of EC. To further promote the quality control for standardized diagnosis and treatment of EC, the National Cancer Center commissioned the Esophageal Cancer Quality Control Expert Committee to draft and formulate the Chinese Quality Control Indices for Standardized Diagnosis and Treatment of Esophageal Cancer (2022 edition). The Indices includes 21 items that cover all key areas in the diagnosis and treatment of esophageal cancer, such as medical oncology, radiation oncology, endoscopy, and pathology.</p></div>","PeriodicalId":73987,"journal":{"name":"Journal of the National Cancer Center","volume":"3 3","pages":"Pages 167-174"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45667449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of the expression pattern of HER2 and its correlation with HER2-targeting antibody-drug conjugate therapy in urothelial cancer","authors":"Huizi Lei ,&nbsp;Yun Ling ,&nbsp;Pei Yuan ,&nbsp;Xieqiao Yan ,&nbsp;Lin Wang ,&nbsp;Yanxia Shi ,&nbsp;Xin Yao ,&nbsp;Hong Luo ,&nbsp;Benkang Shi ,&nbsp;Jiyan Liu ,&nbsp;Zhisong He ,&nbsp;Guohua Yu ,&nbsp;Weiqing Han ,&nbsp;Changlu Hu ,&nbsp;Zhihong Chi ,&nbsp;Chuanliang Cui ,&nbsp;Lu Si ,&nbsp;Jianmin Fang ,&nbsp;Jun Guo ,&nbsp;Xinan Sheng ,&nbsp;Jianming Ying","doi":"10.1016/j.jncc.2023.02.003","DOIUrl":"10.1016/j.jncc.2023.02.003","url":null,"abstract":"<div><h3>Background</h3><p>Human epidermal growth factor receptor 2 (HER2) overexpression is related to anti-HER2 therapy in many tumors. RC48- antibody-drug conjugate (ADC) has shown promising efficacy in patients with HER2-positive locally advanced or metastatic urothelial carcinoma (UC). The characteristic expression and scoring systems of HER2 are nonexistent in UC. We aimed to explore HER2 status and its correlation with the efficacy of HER2-targeting ADC therapy in UC.</p></div><div><h3>Methods</h3><p>A total of 137 and 43 patients were enrolled in cohort 1 and cohort 2, respectively, from March 2009 to December 2018. The patients in cohort 2 were enrolled in a phase II study of RC48-ADC. UC samples were tested for HER2 status using immunohistochemistry (IHC) and/or fluorescence <em>in situ</em> hybridization (FISH). The 2018 ASCO/CAP HER2 scoring system was adopted and modified to score HER2 expression in UC.</p></div><div><h3>Results</h3><p>The HER2-positive (IHC 2+ or 3+) rate was 24.1% (33/137). In HER2 IHC 2+ or 3+ patients, the <em>HER2</em> gene amplification rate was 31% (13/42). The objective response rates (ORRs) in RC48-ADC-treated patients with IHC 3+, IHC 2+ and FISH+, IHC 2+ and FISH- were 58.8%, 66.7% and 40%, respectively. The ORR showed a trend toward a better benefit for RC48-ADC therapy in patients with <em>HER2</em> amplification than in those without amplification (61.5% vs. 44.8%, <em>P</em> <em>=</em> 0.059). The heterogeneity of HER2 expression in the primary tumor was 55.5% (15/27), and the ORR was not significantly different between patients with tumor heterogeneity and homogeneity.</p></div><div><h3>Conclusions</h3><p>IHC testing should be performed to assess the HER2 status before the initiation of HER2-ADC therapy. There was a trend toward a better benefit for patients with <em>HER2</em> amplification, and tumor heterogeneity did not influence the drug efficacy.</p></div>","PeriodicalId":73987,"journal":{"name":"Journal of the National Cancer Center","volume":"3 2","pages":"Pages 121-128"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45006811","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"National Cancer Institute's early detection research network: a model organization for biomarker research","authors":"Paul D. Wagner,&nbsp;Sudhir Srivastava","doi":"10.1016/j.jncc.2023.05.002","DOIUrl":"10.1016/j.jncc.2023.05.002","url":null,"abstract":"<div><p>For many cancers a primary cause of poor survival is that they are detected at a late stage when therapies are less effective. Although screening methods exist to detect some types of cancer at an early stage, there are currently no effective methods to screen for most types of cancer. Biomarkers have the potential to improve detection of early-stage cancers, risk stratification, and prediction of which pre-cancerous lesions are likely to progress and to make screening tests less invasive. Although thousands of research articles on biomarkers for early detection are published every year, few of these biomarkers have been validated and shown to be clinically useful. This reflects both the inherent difficulty in detecting early-stage cancers and a disconnect between the process of discovering biomarkers and their use in the clinic. To overcome this limitation the US National Cancer Institute created the Early Detection Research Network. It is a highly collaborative program that brings together biomarker discoverers, assay developers, and clinicians. It provides an infrastructure that is essential for developing and validating biomarkers and imaging methods for early cancer detection and has successfully completed several multicenter validation studies.</p></div>","PeriodicalId":73987,"journal":{"name":"Journal of the National Cancer Center","volume":"3 2","pages":"Pages 93-99"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42183910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Heterogeneity and function of cancer-associated fibroblasts in renal cell carcinoma","authors":"Haijia Tang ,&nbsp;Wenhao Xu ,&nbsp;Jiahe Lu ,&nbsp;Aihetaimujiang Anwaier ,&nbsp;Dingwei Ye ,&nbsp;Hailiang Zhang","doi":"10.1016/j.jncc.2023.04.001","DOIUrl":"10.1016/j.jncc.2023.04.001","url":null,"abstract":"<div><p>With the advancement of anticancer therapy, there is increasing interest in understanding the tumor microenvironment (TME). Cancer-associated fibroblasts (CAFs) play a pivotal role in the TME and have been the focus of much research in recent years. CAFs play an active role in cancer progression through complex interactions with other cells in the TME, releasing regulatory factors, synthesizing and remodeling the extracellular matrix. However, research on the role of CAFs in renal cell carcinoma (RCC) is still in its nascent stages. Here, we describe the origins and subgroups of CAFs, the roles of CAFs in the development and progression of RCC, the impact of CAFs on RCC prognosis, and the potential of CAFs as treatment targets in RCC. By analyzing CAF subsets, biomarkers, and targeted therapies, we present the significance and contribution of CAFs in RCC research. Furthermore, we highlight the distinct contribution of CAFs in advanced RCC through horizontal comparison with other cancers. This paper provides a comprehensive perspective of recent and foundational studies on the role of CAFs in RCC and other types of cancers and new insights for further study of CAFs in RCC.</p></div>","PeriodicalId":73987,"journal":{"name":"Journal of the National Cancer Center","volume":"3 2","pages":"Pages 100-105"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49653127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quality assurance and safety of hippocampal avoidance prophylactic cranial irradiation in the multicenter randomized phase III trial (NCT01780675)","authors":"Oscar Candiff ,&nbsp;José Belderbos ,&nbsp;Anne Lisa Wolf ,&nbsp;Eugène Damen ,&nbsp;Paul van Haaren ,&nbsp;Wouter Crijns ,&nbsp;Sandra Hol ,&nbsp;Leen Paelinck ,&nbsp;Zdenko van Kesteren ,&nbsp;Jaap Jaspers ,&nbsp;Geert de Kerf ,&nbsp;Wouter van Elmpt ,&nbsp;Fred Ubbels ,&nbsp;Sanne Schagen ,&nbsp;Dirk de Ruysscher ,&nbsp;Michiel de Ruiter","doi":"10.1016/j.jncc.2023.05.004","DOIUrl":"10.1016/j.jncc.2023.05.004","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;p&gt;NCT01780675, a multicenter randomized phase III trial of prophylactic cranial irradiation (PCI) versus PCI with hippocampal sparing in small cell lung cancer (SCLC) investigated neurocognitive decline and safety. As part of quality assurance, we evaluated if hippocampal avoidance (HA)-PCI was performed according to the NCT01780675 trial protocol instructions, and performed a safety analysis to study the incidence and location of brain metastases for patients treated with HA-PCI.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;p&gt;This retrospective analysis evaluated the quality of the irradiation given in the randomized controlled trial (RCT) comparing SCLC patients receiving PCI with or without hippocampal avoidance, using intensity modulated radiotherapy (IMRT) or volumetric modulated arc therapy (VMAT). The dose distribution for each patient receiving HA-PCI was retrieved and analyzed to evaluate if the treatment dose constraints were met. A questionnaire was sent out to all participating sites, and data on radiotherapy technique, pre-treatment dummy runs, phantom measurements and treatment electronic portal imaging device (EPID) dosimetry were collected and analyzed. As part of the safety analysis, the follow-up magnetic resonance imaging (MRI) or computerized tomography (CT) scans on which cranial disease progression was first diagnosed were collected and matched to the radiotherapy planning dose distribution. The matched scans were reviewed to analyze the location of the brain metastases in relation to the prescribed dose.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;p&gt;A total of 168 patients were randomized in the NCT01780675 trial in 10 centers in the Netherlands and Belgium from April 2013 until March 2018. Eighty two patients receiving HA-PCI without evidence of brain metastases were analyzed. All patients were treated with 25 Gy in 10 fractions. Dummy runs and phantom measurements were performed in all institutions prior to enrolling patients into the study. The radiotherapy (RT) plans showed a median mean bilateral hippocampal dose of 8.0 Gy, range 5.4–11.4 (constraint ≤ 8.5 Gy). In six patients (7.3%) there was a protocol violation of the mean dose in one or both hippocampi. In four of these six patients (4.9%) the mean dose to both hippocampi exceeded the constraint, in 1 patient (1.2%) only the left and in 1 patient (1.2%) only the right hippocampal mean dose was violated (average median dose left and right 8.9 Gy). All patients met the trial dose constraint of &lt;em&gt;V&lt;/em&gt;&lt;sub&gt;115%&lt;/sub&gt; &lt;em&gt;PTV&lt;/em&gt; ≤ 1%; however the &lt;em&gt;D&lt;/em&gt;&lt;sub&gt;max&lt;/sub&gt; &lt;em&gt;PTV&lt;/em&gt; constraint of ≤ 28.75 Gy was violated in 22.0% of the patients. The safety analysis showed that 14 patients (17.1%) developed cranial progression. No solitary brain metastases in the underdosed region were found. Two out of 11 patients with multiple brain metastasis developed metastasis in the underdosed region(s).&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;p&gt;The radiotherapy quality within the ","PeriodicalId":73987,"journal":{"name":"Journal of the National Cancer Center","volume":"3 2","pages":"Pages 135-140"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42841679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Precision based approach to tailoring radiotherapy in the multidisciplinary management of pediatric central nervous system tumors","authors":"Christina Phuong ,&nbsp;Bo Qiu ,&nbsp;Sabine Mueller ,&nbsp;Steve E. Braunstein","doi":"10.1016/j.jncc.2023.03.001","DOIUrl":"10.1016/j.jncc.2023.03.001","url":null,"abstract":"<div><p>Modern day survivorship from childhood malignancies is estimated to be over 80%. However, central nervous system tumors remain the leading cause of cancer mortality in children and is the most common solid tumor in this population. Improved survivorship is, in part, a result of improved multidisciplinary care, often with a combination of surgery, radiation therapy, and systemic therapy. With improved survival, long term effects of treatment and quality of life impacts have been recognized and pose a challenge to maximize the therapeutic ratio of treatment. It has been increasingly more apparent that precise risk stratification, such as with the inclusion of molecular classification, is instrumental in efforts to tailor radiotherapy for appropriate treatment, generally towards de-intensification for this vulnerable patient population. In addition, advances in radiotherapy techniques have allowed greater conformality and accuracy of treatment for those who do require radiotherapy for tumor control. Ongoing efforts to tailor radiotherapy, including de-escalation, omission, or intensification of radiotherapy, continue to improve as increasing insight into tumor heterogeneity is recognized, coupled with advances in precision medicine employing novel molecularly-targeted therapeutics.</p></div>","PeriodicalId":73987,"journal":{"name":"Journal of the National Cancer Center","volume":"3 2","pages":"Pages 141-149"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42252218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}