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Seminars in Radiation Oncology

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https://www.readbyqxmd.com/read/27986215/beyond-just-androgen-deprivation-therapy-novel-therapies-combined-with-radiation
#1
REVIEW
Oliver Sartor, Brian Lewis
External beam radiation therapy (EBRT) combined with androgen deprivation are standard of care for selected patients with prostate cancer. In recent years, multiple therapies have been experimentally combined with EBRT either concomitantly or adjuvantly. These therapies include chemotherapies, immunotherapies, and novel hormones. In addition to EBRT, clinical trials with radiopharmaceuticals are planned or have been performed with concomitant chemotherapy, immunotherapies, novel hormones, and inhibitors of DNA damage repair...
January 2017: Seminars in Radiation Oncology
https://www.readbyqxmd.com/read/27986214/management-of-node-positive-and-oligometastatic-prostate-cancer
#2
REVIEW
James R Broughman, Ronald C Chen
Historically, stage IV prostate cancer was considered incurable. Although node-positive and oligometastatic prostate cancers are both classified as stage IV, these likely represent distinct clinical groups, and some patients may be curable with aggressive multimodality treatments. There is a lack of randomized evidence, but retrospective studies suggest that radical prostatectomy or radiotherapy may improve survival in these patients. This is an area of great current research interest and prospective randomized trials are needed to help define the optimal treatments for these patients...
January 2017: Seminars in Radiation Oncology
https://www.readbyqxmd.com/read/27986213/options-for-salvage-of-radiation-failures-for-prostate-cancer
#3
REVIEW
Audrey Tetreault-Laflamme, Juanita Crook
Biochemical failure after primary external beam radiotherapy for prostate cancer is common, and a significant proportion of these failures are due to local residual or recurrent disease. Early or delayed palliation using androgen deprivation therapy is the most common approach. Although a conservative approach is appropriate for many individuals, selected patients would benefit from retreatment with curative intent. We review the pertinent literature on salvage of locally recurrent prostate cancer after primary radiotherapy, including the modalities of surgery, cryotherapy, high-intensity focused ultrasound, or reirradiation with brachytherapy or stereotactic body radiotherapy...
January 2017: Seminars in Radiation Oncology
https://www.readbyqxmd.com/read/27986212/postoperative-radiation-after-radical-prostatectomy
#4
REVIEW
Eric C Ko, Anthony L Michaud, Richard K Valicenti
A total of 3 randomized clinical trials have demonstrated a significant clinical benefit with adjuvant radiation in patients with high-risk prostate cancer after radical prostatectomy, with each showing improved biochemical control outcomes, and one trial (SWOG 8794) also demonstrating increased overall survival. How broadly these results have informed clinical practice has evolved over time, given the widespread availability of ultrasensitive prostate-specific antigen level testing and increased awareness that the high-risk patients are not a uniform cohort...
January 2017: Seminars in Radiation Oncology
https://www.readbyqxmd.com/read/27986211/optimization-of-the-radiation-management-of-high-risk-prostate-cancer
#5
REVIEW
Paul L Nguyen
Radiation and androgen-deprivation therapy (ADT) are mainstays of treatment for men with high-risk prostate cancer. High-risk disease is heterogeneous and subcategories of "favorable" high risk and very high risk can identify subgroups with particularly good or poor prognosis to help personalize treatment. Overall, randomized trials show that the combination of radiation and ADT improves survival when compared with either by itself. The optimum duration of ADT remains controversial, but for most healthy men with aggressive disease, approximately 2-3 years of ADT is well supported by the literature...
January 2017: Seminars in Radiation Oncology
https://www.readbyqxmd.com/read/27986210/emerging-technologies-and-techniques-in-radiation-therapy
#6
REVIEW
William J Magnuson, Amandeep Mahal, James B Yu
The past decade has brought an improved ability to precisely target and deliver radiation as well as other focal prostate-directed therapy. Stereotactic body radiotherapy (SBRT), proton beam radiation, high-dose-rate (HDR) brachytherapy, as well as nonradiotherapy treatments such as cryoablation and high-intensity focused ultrasound are several therapeutic modalities that have been investigated for the treatment of prostate cancer in an attempt to reduce toxicity while improving cancer control. However, high-risk prostate cancer requires a comprehensive treatment of the prostate as well as areas at risk for cancer spread...
January 2017: Seminars in Radiation Oncology
https://www.readbyqxmd.com/read/27986209/prostate-cancer-genetics-variation-by-race-ethnicity-and-geography
#7
REVIEW
Timothy R Rebbeck
Prostate cancer rates vary substantially by race, ethnicity, and geography. These disparities can be explained by variation in access to screening and treatment, variation in exposure to prostate cancer risk factors, and variation in the underlying biology of prostate carcinogenesis (including genomic propensity of some groups to develop biologically aggressive disease). It is clear that access to screening and access to treatment are critical influencing factors of prostate cancer rates; yet, even among geographically diverse populations with similar access to care (eg, low- and medium-income countries), African descent men have higher prostate cancer rates and poorer prognosis...
January 2017: Seminars in Radiation Oncology
https://www.readbyqxmd.com/read/27986208/advances-in-prostate-cancer-magnetic-resonance-imaging-and-positron-emission-tomography-computed-tomography-for-staging-and-radiotherapy-treatment-planning
#8
REVIEW
Drew Moghanaki, Baris Turkbey, Neha Vapiwala, Behfar Ehdaie, Steven J Frank, Patrick W McLaughlin, Mukesh Harisinghani
Conventional prostate cancer staging strategies have limited accuracy to define the location, grade, and burden of disease. Evaluations have historically relied upon prostate-specific antigen levels, digital rectal examinations, random systematic biopsies, computed tomography, pelvic lymphadenectomy, or (99m)technetium methylene diphosphonate bone scans. Today, risk-stratification tools incorporate these data in a weighted format to guide management. However, the limitations and potential consequences of their uncertainties are well known...
January 2017: Seminars in Radiation Oncology
https://www.readbyqxmd.com/read/27986207/biomarkers-of-outcome-in-patients-with-localized-prostate-cancer-treated-with-radiotherapy
#9
REVIEW
William A Hall, Colleen A Lawton, Ashesh B Jani, Alan Pollack, Felix Y Feng
Prostate cancer represents one of the most prevalent malignancies in the world. Although subsets of prostate cancer are aggressive and can metastasize, it is also evident that most patients harbor indolent disease. Although current risk-stratification approaches use both clinical and pathologic factors, it is clear that biomarkers can be used to improve on these approaches. In this article, we review the currently published literature on prostate cancer molecular biomarkers, primarily in the context of radiation therapy, focusing on those found in serum, plasma, urine, and within the tumor biopsy itself...
January 2017: Seminars in Radiation Oncology
https://www.readbyqxmd.com/read/27986206/introduction
#10
EDITORIAL
Jason A Efstathiou
No abstract text is available yet for this article.
January 2017: Seminars in Radiation Oncology
https://www.readbyqxmd.com/read/27619256/current-instrumentation-and-technologies-in-modern-radiobiology-research-opportunities-and-challenges
#11
REVIEW
Eric Ford, Jim Deye
There is a growing awareness of the gaps in the technical methods employed in radiation biology experiments. These quality gaps can have a substantial effect on the reliability and reproducibility of results as outlined in several recent meta-studies. This is especially true in the context of the newer laboratory irradiation technologies. These technologies allow for delivery of highly localized dose distributions and increased spatial accuracy but also present increased challenges of their own. In this article, we highlight some of the features of the new technologies and the experiments they support; this includes image-guided localized radiation systems, microirradiator systems using carbon nanotubes and physical radiation modifiers like gold nanoparticles...
October 2016: Seminars in Radiation Oncology
https://www.readbyqxmd.com/read/27619255/new-strategies-for-multimodality-therapy-in-treating-locally-advanced-cervix-cancer
#12
REVIEW
Jonathan Verma, Bradley J Monk, Aaron H Wolfson
Cervical cancer is the fourth most common cause of cancer of women worldwide. In the developing world, it comprises 12% of all cancers of women. Since 1999, the mainstay of treatment for locally advanced cervical cancer (LACC) has been concurrent cisplatin-based chemoradiation. However, outcomes in this disease remain suboptimal, with long-term progression-free survival and overall survival rates of approximately 60%. There are several new strategies of combined modality treatment under evaluation in LACC, including chemotherapy before and after treatment as well as novel agents such as poly-adenosine diphosphate ribose polymerase inhibitors, antiangiogenic blockage, and immunotherapy...
October 2016: Seminars in Radiation Oncology
https://www.readbyqxmd.com/read/27619254/targeted-therapy-for-hepatocellular-carcinoma
#13
REVIEW
Nitin Ohri, Andreas Kaubisch, Madhur Garg, Chandan Guha
Hepatocellular cancer (HCC) is a leading cause of cancer death worldwide, and most patients who are diagnosed with HCC are ineligible for curative local therapy. The targeted agent sorafenib provides modest survival benefits in the setting of advanced disease. Novel systemic treatment options for HCC are sorely needed. In this review, we identify and categorize the drugs and targets that are in various phases of testing for use against HCC. We also focus on the potential for combining these agents with radiotherapy...
October 2016: Seminars in Radiation Oncology
https://www.readbyqxmd.com/read/27619253/recent-advances-and-prospects-for-multimodality-therapy-in-pancreatic-cancer
#14
REVIEW
Awalpreet S Chadha, Allison Khoo, Maureen L Aliru, Harpreet K Arora, Jillian R Gunther, Sunil Krishnan
The outcomes for treatment of pancreatic cancer have not improved dramatically in many decades. However, the recent promising results with combination chemotherapy regimens for metastatic disease increase optimism for future treatments. With greater control of overt or occult metastatic disease, there will likely be an expanding role for local treatment modalities, especially given that nearly a third of pancreatic cancer patients have locally destructive disease without distant metastatic disease at the time of death...
October 2016: Seminars in Radiation Oncology
https://www.readbyqxmd.com/read/27619252/successes-and-failures-of-combined-modalities-in-upper-gastrointestinal-malignancies-new-directions
#15
REVIEW
Daniel S Jamorabo, Steven H Lin, Salma K Jabbour
Upper gastrointestinal malignancies generally have moderate to poor cure rates, even in the earliest stages, thereby implying that both local and systemic treatments have room for improvement. Therapeutic options are broadening, however, with the development of new immunotherapies and targeted agents, which can have synergistic effects with radiotherapy. Here we discuss the current state of combined modality therapy for upper gastrointestinal malignancies, specifically recent successes and setbacks in trials of radiation therapy with targeted therapies, vaccines, immunotherapies, and chemotherapies...
October 2016: Seminars in Radiation Oncology
https://www.readbyqxmd.com/read/27619251/successes-and-failures-of-combined-modality-therapies-in-head-and-neck-cancer
#16
REVIEW
Daniel W Bowles, Eric Deutsch, David Raben
The paradigms for treating head and neck squamous cell carcinoma are changing as new subgroups are defined. The technical successes of improved radiation therapy are many; however, the success of novel combined therapies are few. With the emergence of human papillomavirus and the development of immunooncology agents, such as checkpoint inhibitors, are we ready to reevaluate how we use radiation and chemotherapy for locally advanced and metastatic disease-will we remain the fire or become the fire starter?
October 2016: Seminars in Radiation Oncology
https://www.readbyqxmd.com/read/27619250/success-and-failures-of-combined-modalities-in-glioblastoma-multiforme-old-problems-and-new-directions
#17
REVIEW
Christopher D Corso, Ranjit S Bindra
Glioblastoma multiforme (GBM) is an aggressive intracranial tumor characterized by local and distant brain relapse despite aggressive therapy. Current standard treatment includes surgical resection followed by radiation with concurrent and adjuvant temozolomide as part of a combined modality approach. In this review, the historical basis for the current standard treatment is discussed as well as other recent combined modality successes and failures. An overview of emerging combined modality therapies for GBM is presented including immunotherapy, and rationally designed radiosensitizers...
October 2016: Seminars in Radiation Oncology
https://www.readbyqxmd.com/read/27619249/radiation-therapeutic-agent-clinical-trials-leveraging-advantages-of-a-national-cancer-institute-programmatic-collaboration
#18
REVIEW
Naoko Takebe, Mansoor M Ahmed, Bhadrasain Vikram, Eric J Bernhard, James Zwiebel, C Norman Coleman, Charles A Kunos
A number of oncology phase II radiochemotherapy trials with promising results have been conducted late in the overall experimental therapeutic agent development process. Accelerated development and approval of experimental therapeutic agents have stimulated further interest in much earlier radiation-agent studies to increase the likelihood of success in phase III trials. To sustain this interest, more forward-thinking preclinical radiobiology experimental designs are needed to improve discovery of promising radiochemotherapy plus agent combinations for clinical trial testing...
October 2016: Seminars in Radiation Oncology
https://www.readbyqxmd.com/read/27619248/translation-of-targeted-radiation-sensitizers-into-clinical-trials
#19
REVIEW
Zachery R Reichert, Daniel R Wahl, Meredith A Morgan
Over the past century, technologic advances have promoted the evolution of radiation therapy into a precise treatment modality allowing for the maximal administration of dose to tumors while sparing normal tissues. Coinciding with this technological maturation, systemic therapies have been combined with radiation in an effort to improve tumor control. Conventional cytotoxic agents have improved survival in several tumor types but cause increased toxicity due to effects on normal tissues. An increased understanding of tumor biology and the radiation response has led to the nomination of several pathways whose targeted inhibition has the potential to radiosensitize tumor cells with lesser effects on normal tissues...
October 2016: Seminars in Radiation Oncology
https://www.readbyqxmd.com/read/27619247/exploiting-gene-expression-kinetics-in-conventional-radiotherapy-hyperfractionation-and-hypofractionation-for-targeted-therapy
#20
REVIEW
Adeola Y Makinde, Iris Eke, Molykutty J Aryankalayil, Mansoor M Ahmed, C Norman Coleman
The dramatic changes in the technological delivery of radiation therapy, the repertoire of molecular targets for which pathway inhibitors are available, and the cellular and immunologic responses that can alter long-term clinical outcome provide a potentially unique role for using the radiation-inducible changes as therapeutic targets. Various mathematical models of dose and fractionation are extraordinarily useful in guiding treatment regimens. However, although the model may fit the clinical outcome, a deeper understanding of the molecular and cellular effect of the individual dose size and the adaptation to repeated exposure, called multifraction (MF) adaptation, may provide new therapeutic targets for use in combined modality treatments using radiochemotherapy and radioimmunotherapy...
October 2016: Seminars in Radiation Oncology
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