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Seminars in Radiation Oncology

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https://www.readbyqxmd.com/read/27619256/current-instrumentation-and-technologies-in-modern-radiobiology-research-opportunities-and-challenges
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
https://www.readbyqxmd.com/read/27619246/current-insights-in-radiation-combination-therapies-influence-of-omics-and-novel-targeted-agents-in-defining-new-concepts-in-radiation-biology-and-clinical-radiation-oncology
#11
EDITORIAL
Mansoor M Ahmed, Amogh Narendra, Pataje Prasanna, C Norman Coleman, Sunil Krishnan
No abstract text is available yet for this article.
October 2016: Seminars in Radiation Oncology
https://www.readbyqxmd.com/read/27238476/toward-restored-bowel-health-in-rectal-cancer-survivors
#12
REVIEW
Gunnar Steineck, Heike Schmidt, Eleftheria Alevronta, Fei Sjöberg, Cecilia Magdalena Bull, Dirk Vordermark
As technology gets better and better, and as clinical research provides more and more knowledge, we can extend our ambition to cure patients from cancer with restored physical health among the survivors. This increased ambition requires attention to grade 1 toxicity that decreases quality of life. It forces us to document the details of grade 1 toxicity and improve our understanding of the mechanisms. Long-term toxicity scores, or adverse events as documented during clinical trials, may be regarded as symptoms or signs of underlying survivorship diseases...
July 2016: Seminars in Radiation Oncology
https://www.readbyqxmd.com/read/27238475/irradiation-of-very-locally-advanced-and-recurrent-rectal-cancer
#13
REVIEW
Michael G Haddock
Adjuvant therapy with chemoradiation or short-course radiation in addition to improvements in surgical technique has led to improved outcomes for patients with locally advanced rectal cancer. Local recurrence rates of less than 10% and 5-year survival rate of 60% or higher is expected. However, for patients with very locally advanced primary or locally recurrent disease in whom surgical resection is likely to be associated with incomplete resection, survival and disease control rates are poor and standard doses of adjuvant radiation or chemoradiation are relatively ineffective...
July 2016: Seminars in Radiation Oncology
https://www.readbyqxmd.com/read/27238474/advancing-techniques-of-radiation-therapy-for-rectal-cancer
#14
REVIEW
Sagar A Patel, Jennifer Y Wo, Theodore S Hong
Since the advent of radiation therapy for rectal cancer, there has been continual investigation of advancing technologies and techniques that allow for improved dose conformality to target structures while limiting irradiation of surrounding normal tissue. For locally advanced disease, intensity modulated and proton beam radiation therapy both provide more highly conformal treatment volumes that reduce dose to organs at risk, though the clinical benefit in terms of toxicity reduction is unclear. For early stage disease, endorectal contact therapy and high-dose rate brachytherapy may be a definitive treatment option for patients who are poor operative candidates or those with low-lying tumors that desire sphincter-preservation...
July 2016: Seminars in Radiation Oncology
https://www.readbyqxmd.com/read/27238473/drug-combinations-in-preoperative-chemoradiation-for-rectal-cancer
#15
REVIEW
Rob Glynne-Jones, Carlos Carvalho
Preoperative radiotherapy has an accepted role in reducing the risk of local recurrence in locally advanced resectable rectal cancer, particularly when the circumferential resection margin is breached or threatened, according to magnetic resonance imaging. Fluoropyrimidine-based chemoradiation can obtain a significant down-sizing response and a curative resection can then be achieved. Approximately, 20% of the patients can also obtain a pathological complete response, which is associated with less local recurrences and increased survival...
July 2016: Seminars in Radiation Oncology
https://www.readbyqxmd.com/read/27238472/definitive-chemoradiotherapy-watch-and-wait-approach
#16
REVIEW
Karyn A Goodman
Preoperative chemoradiotherapy (CRT) followed by total mesorectal excision has been the standard of care for locally advanced patients with rectal cancer. Some patients achieve a pathologic complete response (pCR) to CRT and the oncologic outcomes are particularly favorable in this group. The role of surgery in patients with a pCR is now being questioned as radical rectal resection is associated with significant morbidity and long-term effects on quality of life. In an attempt to better tailor therapy, there is an interest in a "watch-and-wait" approach in patients who have a clinical complete response (cCR) after CRT with the goal of omitting surgery and allowing for organ preservation...
July 2016: Seminars in Radiation Oncology
https://www.readbyqxmd.com/read/27238471/which-patients-with-rectal-cancer-do-not-need-radiotherapy
#17
REVIEW
Ines Joye, Karin Haustermans
According to current guidelines, the standard treatment for locally advanced rectal cancer patients is preoperative (chemo)radiotherapy followed by total mesorectal excision surgery and adjuvant chemotherapy. Improvements in surgical techniques, imaging modalities, chemotherapy regimens, and radiotherapy delivery have reduced local recurrence rates to less than 10%. The current challenge in rectal cancer treatment lies in the prevention of distant metastases, which still occur in more than 25% of the patients...
July 2016: Seminars in Radiation Oncology
https://www.readbyqxmd.com/read/27238470/magnetic-resonance-imaging-and-other-imaging-modalities-in-diagnostic-and-tumor-response-evaluation
#18
REVIEW
Doenja M J Lambregts, Monique Maas, Marcel P M Stokkel, Regina G H Beets-Tan
Functional imaging is emerging as a valuable contributor to the clinical management of patients with rectal cancer. Techniques such as diffusion-weighted magnetic resonance imaging, perfusion imaging, and positron emission tomography can offer meaningful insights into tissue architecture, vascularity, and metabolism. Moreover, new techniques targeting other aspects of tumor biology are now being developed and studied. This study reviews the potential role of functional imaging for the diagnosis, treatment monitoring, and assessment of prognosis in patients with rectal cancer...
July 2016: Seminars in Radiation Oncology
https://www.readbyqxmd.com/read/27238469/preoperative-treatment-of-locally-advanced-rectal-cancer-assets-and-drawbacks-of-short-course-and-long-course-in-clinical-practice
#19
REVIEW
Samuel Y Ngan
Preoperative short-course radiotherapy and preoperative long-course chemoradiotherapy are the standards of care for high-risk rectal cancer in different parts of the world. Both treatments are effective in local control and carry a low morbidity. The advantage of short course is its simplicity, whereas long course has the advantage of downsizing tumors thus increasing the chance of sphincter preservation. Although 2 randomized trials comparing short course and long course have been performed, the better form of preoperative treatment remains a subject of discussion...
July 2016: Seminars in Radiation Oncology
https://www.readbyqxmd.com/read/27238468/timing-of-therapies-in-the-multidisciplinary-treatment-of-locally-advanced-rectal-cancer-available-evidence-and-implications-for-routine-practice
#20
REVIEW
Francesco Sclafani, Ian Chau
A multimodality disciplinary approach is paramount for the management of locally advanced rectal cancer. Over the last decade, (chemo)radiotherapy followed by surgery plus or minus adjuvant chemotherapy has represented the mainstay of treatment for this disease. Nevertheless, robust evidence suggesting the optimal timing and sequence of therapies in this setting has been overall limited. A number of questions are still unsolved including the length of the interval between neoadjuvant radiotherapy and surgery or the timing of systemic chemotherapy...
July 2016: Seminars in Radiation Oncology
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