Cancer journalPub Date : 2024-11-01DOI: 10.1097/PPO.0000000000000756
Elizabeth L Covington, Richard A Popple
{"title":"Technical and Quality Considerations for Stereotactic Radiation Treatment Techniques.","authors":"Elizabeth L Covington, Richard A Popple","doi":"10.1097/PPO.0000000000000756","DOIUrl":"https://doi.org/10.1097/PPO.0000000000000756","url":null,"abstract":"<p><strong>Abstract: </strong>Stereotactic radiosurgery (SRS) and stereotactic body radiation therapy (SBRT), collectively termed SRS-SBRT, are advanced treatment modalities delivering high doses of radiation in a single treatment or condensed treatment phase. Due to the small margins and steep dose gradient used in SRS-SBRT, the technical and safety considerations are more stringent than traditional radiation therapy and may include more advanced simulation, patient immobilization, treatment planning, and treatment delivery techniques. Respiratory motion management and intrafraction motion monitoring are often used during SRS-SBRT to ensure treatments are robust to both internal organ motion and patient movement during treatment. To ensure optimal treatment quality, SRS-SBRT programs should use multidisciplinary coordination of care to ensure patient-specific treatment strategies are used for optimal patient outcomes. Quality and safety considerations are presented, including peer review and external validation, for optimizing quality and adhering to national guidelines for stereotactic techniques.</p>","PeriodicalId":9655,"journal":{"name":"Cancer journal","volume":"30 6","pages":"372-376"},"PeriodicalIF":2.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142715546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cancer journalPub Date : 2024-11-01DOI: 10.1097/PPO.0000000000000755
Cristian Udovicich, Simon S Lo, Matthias Guckenberger, Arjun Sahgal
{"title":"Shifting the Landscape of Spine and Non-Spine Bone Metastases: A Review of Stereotactic Body Radiotherapy.","authors":"Cristian Udovicich, Simon S Lo, Matthias Guckenberger, Arjun Sahgal","doi":"10.1097/PPO.0000000000000755","DOIUrl":"https://doi.org/10.1097/PPO.0000000000000755","url":null,"abstract":"<p><strong>Abstract: </strong>Both spine and nonspine bone metastases are frequent sites of spread from solid organ malignancies. As bone metastases frequently cause significant morbidity for patients, it is critical to offer a treatment that can achieve rapid and durable symptomatic relief and local control, without being associated with serious risks of toxicity. Conventional palliative radiation therapy has a key treatment component in the multidisciplinary management of these patients; however, over the past decade, it has evolved to routinely deliver high biologically effective doses with precision in the form of stereotactic body radiation therapy. This change in paradigm is a result of the shifting landscape in cancer care, such that short-term pain relief is no longer the sole therapeutic aim for selected patients, and durable symptom relief and local tumor control are the goals. This review discusses the randomized prospective evidence, ongoing trials, approach to surveillance imaging, and treatment delivery for stereotactic body radiation therapy, to both spine and nonspine bone metastases, with a specific section on sacral metastases.</p>","PeriodicalId":9655,"journal":{"name":"Cancer journal","volume":"30 6","pages":"385-392"},"PeriodicalIF":2.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142715538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cancer journalPub Date : 2024-11-01DOI: 10.1097/PPO.0000000000000751
Elizabeth M Jaworski, Theodore S Lawrence
{"title":"Stereotactic Body Radiation Therapy: Opportunities and Limitations.","authors":"Elizabeth M Jaworski, Theodore S Lawrence","doi":"10.1097/PPO.0000000000000751","DOIUrl":"https://doi.org/10.1097/PPO.0000000000000751","url":null,"abstract":"","PeriodicalId":9655,"journal":{"name":"Cancer journal","volume":"30 6","pages":"377-384"},"PeriodicalIF":2.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142715543","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cancer journalPub Date : 2024-11-01DOI: 10.1097/PPO.0000000000000752
Emily Hollis, David W Nganga, Ted K Yanagihara
{"title":"A Review of Stereotactic Body Radiotherapy in the Management of Gastrointestinal Malignancies.","authors":"Emily Hollis, David W Nganga, Ted K Yanagihara","doi":"10.1097/PPO.0000000000000752","DOIUrl":"https://doi.org/10.1097/PPO.0000000000000752","url":null,"abstract":"<p><strong>Abstract: </strong>In this review, we explore the role of stereotactic body radiotherapy (SBRT) and other advanced radiotherapy techniques in the treatment of gastrointestinal malignancies, which primarily involves primary and secondary liver cancers and pancreatic cancers. The review examines radiotherapy in both curative and palliative settings, emphasizing the evolution of SBRT and hypofractionation as alternatives to conventional radiotherapy. We review the recent literature evaluating radiotherapy in the management of unresectable, borderline resectable, and metastatic pancreatic cancer, highlighting recent advances in radiotherapy techniques that aim to improve local control, reduce toxicity, and increase resectability in appropriate patients. For primary liver cancers (hepatocellular carcinoma and cholangiocarcinoma), SBRT has emerged as a potential noninvasive alternative to surgery, particularly in patients with unresectable tumors or those awaiting liver transplantation. The review also provides insights into ongoing clinical trials, comparative studies between SBRT and other local therapies such as radiofrequency ablation, and the use of radiotherapy in managing liver metastases from various primary cancers. Throughout, we emphasize limitations in the available literature and highlight areas of ongoing and future investigation.</p>","PeriodicalId":9655,"journal":{"name":"Cancer journal","volume":"30 6","pages":"407-420"},"PeriodicalIF":2.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142715527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cancer journalPub Date : 2024-11-01DOI: 10.1097/PPO.0000000000000753
Katie N Lee, Dawn Owen
{"title":"Advances in Stereotactic Body Radiation Therapy for Lung Cancer.","authors":"Katie N Lee, Dawn Owen","doi":"10.1097/PPO.0000000000000753","DOIUrl":"https://doi.org/10.1097/PPO.0000000000000753","url":null,"abstract":"<p><strong>Abstract: </strong>Stereotactic body radiation therapy (SBRT) delivers curative-intent radiation to patients with early-stage non-small cell lung cancer and inoperable thoracic lesions. With improved techniques in tumor delineation, motion management, and delivery of radiation treatments, the therapeutic window within the thorax is able to be maximized. Ongoing technological advances enable highly targeted ablative radiation therapy while sparing adjacent sensitive organs at risk. Further applications of SBRT with combinatorial immunotherapy, the usage of particle therapy, and for patients with more advanced stages of lung cancer and other histologies mark exciting possibilities for the role of SBRT within the thorax.</p>","PeriodicalId":9655,"journal":{"name":"Cancer journal","volume":"30 6","pages":"401-406"},"PeriodicalIF":2.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142715528","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cancer journalPub Date : 2024-11-01DOI: 10.1097/PPO.0000000000000754
Donna M Edwards, Michelle M Kim
{"title":"Effective Personalization of Stereotactic Radiosurgery for Brain Metastases in the Modern Era: Opportunities for Innovation.","authors":"Donna M Edwards, Michelle M Kim","doi":"10.1097/PPO.0000000000000754","DOIUrl":"https://doi.org/10.1097/PPO.0000000000000754","url":null,"abstract":"<p><strong>Abstract: </strong>As survival rates improve for patients with metastatic disease, more patients are requiring complex treatment for brain metastases. Stereotactic radiosurgery (SRS) is a conformal radiotherapy technique that allows high ablative dose to be delivered to a specific target and is a standard effective local therapy for the treatment of patients with limited brain metastases. This review highlights the current landscape of SRS treatment in the context of modern therapeutic advances and identifies new research frontiers to personalize SRS and maximize the therapeutic ratio.</p>","PeriodicalId":9655,"journal":{"name":"Cancer journal","volume":"30 6","pages":"393-400"},"PeriodicalIF":2.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142715536","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cancer journalPub Date : 2024-11-01DOI: 10.1097/PPO.0000000000000750
Alexander D Sherry, Neil Desai, Chad Tang
{"title":"Current State of Stereotactic Body Radiation Therapy for Genitourinary Malignancies.","authors":"Alexander D Sherry, Neil Desai, Chad Tang","doi":"10.1097/PPO.0000000000000750","DOIUrl":"10.1097/PPO.0000000000000750","url":null,"abstract":"<p><strong>Abstract: </strong>Stereotactic body radiation therapy (SBRT) involves the delivery of high-dose, highly precise radiation therapy to focal sites of gross tumor involvement. Recent advances in radiation planning and image guidance have facilitated rapid growth in the evidence for and use of SBRT, particularly for genitourinary malignancies, where the underlying radiobiology often suggests greater tumor sensitivity to SBRT than to conventionally fractionated radiation. Here, we review the evolution of SBRT for patients with prostate adenocarcinoma and renal cell carcinoma. We discuss state-of-the-art trials, indications, and future directions in the SBRT-based management of both localized and metastatic disease. With rapidly growing enthusiasm and evidence, clinical and translational research efforts on the biology and outcomes of SBRT over the coming decade will be crucial to refining the indications, technical approach, and synergistic combinations of SBRT with highly active systemic therapies and improve the efficacy and quality-of-life outcomes for patients with genitourinary malignancies.</p>","PeriodicalId":9655,"journal":{"name":"Cancer journal","volume":"30 6","pages":"421-428"},"PeriodicalIF":2.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11844808/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142715529","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cancer journalPub Date : 2024-09-01DOI: 10.1097/PPO.0000000000000742
PoChung Jordan Chou, Rebecca Mary Peter, Ahmad Shannar, Yuxin Pan, Parv Dushyant Dave, Jiawei Xu, Md Shahid Sarwar, Ah-Ng Kong
{"title":"Epigenetics of Dietary Phytochemicals in Cancer Prevention: Fact or Fiction.","authors":"PoChung Jordan Chou, Rebecca Mary Peter, Ahmad Shannar, Yuxin Pan, Parv Dushyant Dave, Jiawei Xu, Md Shahid Sarwar, Ah-Ng Kong","doi":"10.1097/PPO.0000000000000742","DOIUrl":"10.1097/PPO.0000000000000742","url":null,"abstract":"<p><strong>Abstract: </strong>Cancer development takes 10 to 50 years, and epigenetics plays an important role. Recent evidence suggests that ~80% of human cancers are linked to environmental factors impinging upon genetics/epigenetics. Because advanced metastasized cancers are resistant to radiation/chemotherapeutic drugs, cancer prevention by relatively nontoxic \"epigenetic modifiers\" will be logical. Many dietary phytochemicals possess powerful antioxidant and anti-inflammatory properties that are hallmarks of cancer prevention. Dietary phytochemicals can regulate gene expression of the cellular genome via epigenetic mechanisms. In this review, we will summarize preclinical studies that demonstrate epigenetic mechanisms of dietary phytochemicals in skin, colorectal, and prostate cancer prevention. Key examples of the importance of epigenetic regulation in carcinogenesis include hypermethylation of the NRF2 promoter region in cancer cells, resulting in inhibition of NRF2-ARE signaling. Many dietary phytochemicals demethylate NRF2 promoter region and restore NRF2 signaling. Phytochemicals can also inhibit inflammatory responses via hypermethylation of inflammation-relevant genes to block gene expression. Altogether, dietary phytochemicals are excellent candidates for cancer prevention due to their low toxicity, potent antioxidant and anti-inflammatory properties, and powerful epigenetic effects in reversing procarcinogenic events.</p>","PeriodicalId":9655,"journal":{"name":"Cancer journal","volume":"30 5","pages":"320-328"},"PeriodicalIF":2.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11573353/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142307173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cancer journalPub Date : 2024-09-01DOI: 10.1097/PPO.0000000000000740
Jiangjiang Zhu
{"title":"New Metabolomic Insights Into Cancer.","authors":"Jiangjiang Zhu","doi":"10.1097/PPO.0000000000000740","DOIUrl":"10.1097/PPO.0000000000000740","url":null,"abstract":"<p><strong>Abstract: </strong>Cancer has been marked by metabolic irregularities that fuel various aggressive activities such as rapid cell proliferation, evasion of the immune system, and spread to distant organs. Therefore, exploiting cancer metabolism for diagnosis, monitoring, or treatment has been extensively studied in the past couple of decades with various molecular and cellular techniques. More recently, investigating cancer diagnostics and treatments through advanced metabolomics has emerged, and these comprehensive approaches provide a holistic understanding of cancer metabolism, which supported the discovery of metabolic targets relevant across multiple cancer types and the development of more effective treatments. This study offers highlights of new knowledge on cancer metabolism enabled by recent metabolomics studies and their potential applications in aiding cancer research and predicting cancer treatment outcomes. Specifically, we discussed the use of advanced metabolomics in cancer metabolism, tumor microenvironment, and cancer immunotherapy studies to provide valuable insights that can shape future research efforts in the dynamic field of cancer metabolism research.</p>","PeriodicalId":9655,"journal":{"name":"Cancer journal","volume":"30 5","pages":"301-306"},"PeriodicalIF":2.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11424019/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142307175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cancer journalPub Date : 2024-09-01DOI: 10.1097/PPO.0000000000000746
Nirmal Choradia, Eva Szabo
{"title":"Repurposing Drugs for Cancer Prevention: Targeting Mechanisms Common to Chronic Diseases.","authors":"Nirmal Choradia, Eva Szabo","doi":"10.1097/PPO.0000000000000746","DOIUrl":"10.1097/PPO.0000000000000746","url":null,"abstract":"<p><strong>Abstract: </strong>The development of agents for cancer prevention is a lengthy process requiring a delicate balance between the safety and tolerability of potential interventions and effectiveness in preventing future cancer. Individuals at risk for a specific cancer are frequently at risk for multiple types of cancer as well as other chronic diseases, especially ones associated with aging. Shared environmental exposures, genetic predisposition, metabolic factors, and commonalities in pathogenesis suggest opportunities for combined targeting of cancer and other chronic diseases. Examples discussed here include mechanisms shared between various cancers and obesity, diabetes, and cardiovascular disease.</p>","PeriodicalId":9655,"journal":{"name":"Cancer journal","volume":"30 5","pages":"345-351"},"PeriodicalIF":2.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11424023/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142307176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}