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Seminars in Radiation Oncology

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https://www.readbyqxmd.com/read/29735196/protons-vs-photons-for-brain-and-skull-base-tumors
#1
REVIEW
Safia K Ahmed, Paul D Brown, Robert L Foote
The physical characteristics of proton therapy result in steeper dose gradients and superior dose conformality compared to photon therapy. These properties render proton therapy ideal for skull base tumors requiring dose escalation for optimal tumor control, and may also be beneficial for brain tumors as a means of mitigating radiation-related adverse effects. This review summarizes the literature regarding the role of proton therapy compared to photon therapy in the treatment of adult brain and skull base tumors...
April 2018: Seminars in Radiation Oncology
https://www.readbyqxmd.com/read/29735195/robust-proton-treatment-planning-physical-and-biological-optimization
#2
REVIEW
Jan Unkelbach, Harald Paganetti
Accurate prediction of tumor control and toxicities in radiation therapy faces many uncertainties. Besides interpatient variability in the response to radiation, there are also dosimetric uncertainties, that is, differences between the dose displayed in a treatment planning system and the dose actually delivered to the patient. These uncertainties originate from several sources including imperfect knowledge of the patient geometry, approximation in the physics of radiation interaction with tissues, and uncertainties in the biological effectiveness of radiation...
April 2018: Seminars in Radiation Oncology
https://www.readbyqxmd.com/read/29735194/clinical-trial-strategies-to-compare-protons-with-photons
#3
REVIEW
Johannes A Langendijk, Liesbeth J Boersma, Coen R N Rasch, Marco van Vulpen, Johannes B Reitsma, Arjen van der Schaaf, Ewoud Schuit
The favorable beam properties of protons can be translated into clinical benefits by target dose escalation to improve local control without enhancing unacceptable radiation toxicity or to spare normal tissues to prevent radiation-induced side effects without jeopardizing local tumor control. For the clinical validation of the added value of protons to improve local control, randomized controlled trials are required. For the clinical validation of the added value of protons to prevent side effects, both model-based validation or randomized controlled trials can be used...
April 2018: Seminars in Radiation Oncology
https://www.readbyqxmd.com/read/29735193/charged-issues-particle-radiation-therapy
#4
EDITORIAL
Thomas F DeLaney
No abstract text is available yet for this article.
April 2018: Seminars in Radiation Oncology
https://www.readbyqxmd.com/read/29735192/heavy-charged-particles-does-improved-precision-and-higher-biological-effectiveness-translate-to-better-outcome-in-patients
#5
REVIEW
Marco Durante, Jürgen Debus
Protons are the most common charged particles used in oncology. Acceleration of heavier ions requires larger accelerators and is more expensive, yet heavy nuclei share the same advantageous dose-depth profile characteristics of protons and have potential additional advantages. These advantages are related to the physical characteristics of the beam, owing to reduced lateral scattering and sharper lateral penumbra. In addition, heavy ions produce an increased biological response. In fact, in the target region heavy ions behave as densely ionizing radiation, which produce distinct biological effects compared to sparsely ionizing x-rays and protons...
April 2018: Seminars in Radiation Oncology
https://www.readbyqxmd.com/read/29735191/can-technological-improvements-reduce-the-cost-of-proton-radiation-therapy
#6
REVIEW
Jacobus Maarten Schippers, Anthony Lomax, Adriano Garonna, Katia Parodi
In recent years there has been increasing interest in the more extensive application of proton therapy in a clinical and preferably hospital-based environment. However, broader adoption of proton therapy has been hindered by the costs of treatment, which are still much higher than those in advanced photon therapy. This article presents an overview of on-going technical developments, which have a reduction of the capital investment or operational costs either as a major goal or as a potential outcome. Developments in instrumentation for proton therapy, such as gantries and accelerators, as well as facility layout and efficiency in treatment logistics will be discussed in this context...
April 2018: Seminars in Radiation Oncology
https://www.readbyqxmd.com/read/29735190/potential-morbidity-reduction-with-proton-radiation-therapy-for-breast-cancer
#7
REVIEW
Lior Z Braunstein, Oren Cahlon
Proton radiotherapy confers significant dosimetric advantages in the treatment of malignancies that arise adjacent to critical radiosensitive structures. To date, these advantages have been most prominent in the treatment of pediatric and central nervous system malignancies, although emerging data support the use of protons among other anatomical sites in which radiotherapy plays an important role. With advances in the overall treatment paradigm for breast cancer, most patients with localized disease now exhibit long-term disease control and, consequently, may manifest the late toxicities of aggressive treatment...
April 2018: Seminars in Radiation Oncology
https://www.readbyqxmd.com/read/29735189/finding-value-for-protons-the-case-of-prostate-cancer
#8
REVIEW
Eric Ojerholm, Justin E Bekelman
The standard radiotherapy treatment for prostate cancer is intensity-modulated radiotherapy (IMRT). An alternative option is proton beam therapy (PBT). PBT is a safe and effective treatment, but does it add value over IMRT? We explore this controversial question by examining the available dosimetric and clinical evidence.
April 2018: Seminars in Radiation Oncology
https://www.readbyqxmd.com/read/29735188/will-there-be-a-clinically-significant-role-for-protons-in-patients-with-gastrointestinal-malignancies
#9
REVIEW
Ann C Raldow, Theodore S Hong
Gastrointestinal malignancies inherently arise amidst visceral organs that are very radiation sensitive. While radiation therapy is an integral part of cancer treatment, its use has historically been limited by normal tissue toxicity. Proton therapy is a form of external-beam radiation associated with several dosimetric advantages as compared to photon therapy. Proton radiation may allow for the delivery of tumoricidal doses while minimizing side effects by decreasing the dose to adjacent organs at risk. We discuss the rationale for and challenges of using protons in the treatment of gastrointestinal cancers...
April 2018: Seminars in Radiation Oncology
https://www.readbyqxmd.com/read/29735187/does-proton-therapy-offer-demonstrable-clinical-advantages-for-treating-thoracic-tumors
#10
REVIEW
Zhongxing Liao, Saumil J Gandhi, Steven H Lin, Jeffrey Bradley
The finite range of proton beams in tissues offers unique dosimetric advantages that theoretically allow dose to the target to be escalated while minimizing exposure of surrounding tissues and thus minimizing radiation-induced toxicity. This theoretical advantage has led to widespread adoption of proton therapy around the world for a wide variety of tumors at different anatomical sites. Many treatment-planning comparisons have shown that proton therapy has substantial dosimetric advantages over conventional radiotherapy...
April 2018: Seminars in Radiation Oncology
https://www.readbyqxmd.com/read/29735186/comparing-intensity-modulated-proton-therapy-with-intensity-modulated-photon-therapy-for-oropharyngeal-cancer-the-journey-from-clinical-trial-concept-to-activation
#11
REVIEW
Steven J Frank, Pierre Blanchard, J Jack Lee, Erich M Sturgis, Merrill S Kies, Mitchell Machtay, Bhadrasain Vikram, Adam S Garden, David I Rosenthal, G Brandon Gunn, C David Fuller, Katherine Hutcheson, Stephen Lai, Paul M Busse, Nancy Y Lee, Alexander Lin, Robert L Foote
Intensity-modulated proton therapy minimizes the incidental irradiation of normal tissues in patients with head and neck cancer relative to intensity-modulated photon (x-ray) therapy and has been associated with lesser treatment-related toxicity and improved quality of life. A phase II/III randomized trial sponsored by the US National Cancer Institute is currently underway to compare deintensification treatment strategies with intensity-modulated proton therapy vs intensity-modulated photon (x-ray) therapy for patients with advanced-stage oropharyngeal tumors...
April 2018: Seminars in Radiation Oncology
https://www.readbyqxmd.com/read/29173757/head-and-neck-cancer-survivorship-learning-the-needs-meeting-the-needs
#12
REVIEW
Jolie Ringash, Lori J Bernstein, Gerald Devins, Colleen Dunphy, Meredith Giuliani, Rosemary Martino, Sara McEwen
Cancers of the head and neck and the treatments required to control them frequently result in serious and persistent impairments that can affect participation and quality of life. Increased recognition of the needs of cancer survivors and their caregivers has prompted research focused on the unique concerns of this complex group. Unmet needs have been identified among 60-70% of patients and a similar proportion of their partners; impacts can include profound social effects, isolation, and psychiatric conditions...
January 2018: Seminars in Radiation Oncology
https://www.readbyqxmd.com/read/29173756/proton-therapy-for-head-and-neck-cancers
#13
REVIEW
Pierre Blanchard, Gary Brandon Gunn, Alexander Lin, Robert L Foote, Nancy Y Lee, Steven J Frank
Because of its sharp lateral penumbra and steep distal fall-off, proton therapy offers dosimetric advantages over photon therapy. In head and neck cancer, proton therapy has been used for decades in the treatment of skull-base tumors. In recent years the use of proton therapy has been extended to numerous other disease sites, including nasopharynx, oropharynx, nasal cavity and paranasal sinuses, periorbital tumors, skin, and salivary gland, or to reirradiation. The aim of this review is to present the physical properties and dosimetric benefit of proton therapy over advanced photon therapy; to summarize the clinical benefit described for each disease site; and to discuss issues of patient selection and cost-effectiveness...
January 2018: Seminars in Radiation Oncology
https://www.readbyqxmd.com/read/29173755/organ-sparing-in-radiotherapy-for-head-and-neck-cancer-improving-quality-of-life
#14
REVIEW
Peter G Hawkins, Amrut S Kadam, William C Jackson, Avraham Eisbruch
This is an overview of select studies characterizing the effect of radiation on normal tissues in the treatment of head-and-neck cancer. Recommendations for organ-at-risk dose constraints aiming to reduce risks of xerostomia and dysphagia, the factors which have the highest effect on patient quality of life, are discussed, along with their supporting evidence. Recent advances in technology and biology, and their implications for reducing toxicity are explored. Considerations related to organ-sparing in the setting of treatment deintensification for good-prognosis head-and-neck cancer are also discussed...
January 2018: Seminars in Radiation Oncology
https://www.readbyqxmd.com/read/29173754/molecular-imaging-guided-radiotherapy-for-the-treatment-of-head-and-neck-squamous-cell-carcinoma-does-it-fulfill-the-promises
#15
REVIEW
Vincent Grégoire, Daniela Thorwarth, John Aldo Lee
With the routine use of intensity modulated radiation therapy for the treatment of head-and-neck squamous cell carcinoma allowing highly conformed dose distribution, there is an increasing need for refining both the selection and the delineation of gross tumor volumes (GTV). In this framework, molecular imaging with positron emission tomography and magnetic resonance imaging offers the opportunity to improve diagnostic accuracy and to integrate tumor biology mainly related to the assessment of tumor cell density, tumor hypoxia, and tumor proliferation into the treatment planning equation...
January 2018: Seminars in Radiation Oncology
https://www.readbyqxmd.com/read/29173753/current-status-and-future-directions-of-treatment-deintensification-in-human-papilloma-virus-associated-oropharyngeal-squamous-cell-carcinoma
#16
REVIEW
Bhishamjit S Chera, Robert J Amdur
The prevalence of patients with human papilloma virus (HPV)-associated oropharyngeal squamous cell carcinoma (OPSCC) is rapidly increasing, and it is now well known that these patients have a significantly better prognosis than patients with HPV-negative OPSCC. Though standard treatments result in excellent cancer control, they are also associated with substantial long-term toxicity. There is now great interest in evaluating less intensive (ie, deintensified) treatment regimens to improve the therapeutic ratio (maintain excellent cancer control and decrease toxicity)...
January 2018: Seminars in Radiation Oncology
https://www.readbyqxmd.com/read/29173752/therapeutic-implications-of-the-genetic-landscape-of-head-and-neck-cancer
#17
REVIEW
Janice Cho, Daniel E Johnson, Jennifer R Grandis
Large-scale sequencing studies of head and neck squamous cell carcinoma (HNSCC) have elucidated the genetic changes that characterize HNSCC. These findings have supported the development of therapeutic strategies that target key components of aberrant signaling pathways and immune dysregulation. Cumulative evidence suggests that these agents in combination with radiotherapy may have synergistic effects. This review highlights the predictive biomarkers that have been identified from HNSCC genomic studies and implications on the development of molecular-targeting agents that may effectively treat patients with HNSCC, especially when used in combination with radiation...
January 2018: Seminars in Radiation Oncology
https://www.readbyqxmd.com/read/29173751/the-current-state-of-biological-and-clinical-implications-of-human-papillomavirus-related-oropharyngeal-cancer
#18
REVIEW
Shao Hui Huang, Brian O'Sullivan, John Waldron
In the effort to control human papillomavirus-related oropharyngeal cancer, the head and neck oncology community has devoted much effort to understanding its disease biology and clinical behavior, and refining strategies to address early diagnosis and optimal management for the affected population. This review identifies articles published up to March 2017 on tumor biology and clinical implications of human papillomavirus-related oropharyngeal cancer, and summarizes the findings in some key areas. These include potential screening strategies, possible anatomical features responsible for early lymph node involvement and its implication for staging, biological mechanisms to explain superior outcomes compared to traditional nonviral-related mucosal cancers, re-appreciation of traditional prognostic factors (eg, hypoxia, extranodal extension, and smoking), and current efforts to optimize management for this patient population...
January 2018: Seminars in Radiation Oncology
https://www.readbyqxmd.com/read/29173750/role-of-immunotherapy-in-head-and-neck-cancer
#19
REVIEW
Diane C Ling, Chris J Bakkenist, Robert L Ferris, David A Clump
Immune system dysfunction plays a role in both the development and progression of head and neck squamous cell carcinoma (HNSCC), highlighting the potential role for immunotherapy to improve outcomes in this disease. The application of anti-PD-1 therapies for recurrent or metastatic HNSCC has found promising results. This has led to interest in combining immunotherapy with radiation therapy (RT) for the primary treatment of locally advanced HNSCC. RT with concurrent cetuximab is an option for patients who are medically unfit to receive cisplatin, and ongoing trials seek to determine to role of cetuximab-RT in treatment de-intensification for HPV+ oropharyngeal HNSCC...
January 2018: Seminars in Radiation Oncology
https://www.readbyqxmd.com/read/29173749/introduction
#20
EDITORIAL
Avraham Eisbruch
No abstract text is available yet for this article.
January 2018: Seminars in Radiation Oncology
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