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Seminars in Radiation Oncology

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https://www.readbyqxmd.com/read/29173757/head-and-neck-cancer-survivorship-learning-the-needs-meeting-the-needs
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
EDITORIAL
Avraham Eisbruch
No abstract text is available yet for this article.
January 2018: Seminars in Radiation Oncology
https://www.readbyqxmd.com/read/28865521/emphasis-on-repair-not-just-avoidance-of-injury-facilitates-prudent-stereotactic-ablative-radiotherapy
#10
REVIEW
D W Nathan Kim, Paul M Medin, Robert D Timmerman
Stereotactic ablative radiotherapy (SAbR) is a potent, hypofractionated treatment against cancer which puts adjacent normal tissue in potential peril. Accurate delineation of normal tissue injury risks from SAbR has been challenging, and lack of clear understanding of SAbR tolerance continues to limit its potential. In this review, we contend that SAbR effects on normal tissue could be akin to a surgical "wound," and that adequate wound repair of organs at risk is an essential component of effective SAbR therapy...
October 2017: Seminars in Radiation Oncology
https://www.readbyqxmd.com/read/28865520/thoracic-radiation-normal-tissue-injury
#11
REVIEW
Charles B Simone
Thoracic malignancies are often a difficult group of tumors to treat definitively as the radiation doses needed to achieve a high probability for tumor control are often associated with high rates of radiation-induced toxicities. The lungs are particularly radiosensitive and are susceptible to radiation pneumonitis in the acute and subacute settings and pulmonary fibrosis in the late setting. Acute esophagitis is common and affects patient quality of life. Beyond acute pericarditis, late cardiac toxicities are increasingly being recognized as clinically relevant when delivering thoracic radiotherapy and can affect overall survival...
October 2017: Seminars in Radiation Oncology
https://www.readbyqxmd.com/read/28865519/pelvic-radiation-and-normal-tissue-toxicity
#12
REVIEW
Sarah Nicholas, Linda Chen, Amanda Choflet, Amanda Fader, Zachary Guss, Sarah Hazell, Daniel Y Song, Phuoc T Tran, Akila N Viswanathan
Radiation is a component of treatment for many pelvic malignancies, most often originating in the gynecologic, gastrointestinal, and genitourinary systems. Therefore, the management of acute and long-term side effects is an important part of practice as a radiation oncologist, and limiting morbidity is a primary goal. Toxicities vary and are dependent on treatment techniques. Advances in radiation delivery, imaging, and knowledge of underlying biologic determinants of radiation-induced normal tissue toxicity can guide treatment of acute and long-term side effects from pelvic radiation...
October 2017: Seminars in Radiation Oncology
https://www.readbyqxmd.com/read/28865518/radiation-induced-liver-toxicity
#13
REVIEW
Pablo Munoz-Schuffenegger, Sylvia Ng, Laura A Dawson
The advent of highly conformal radiation therapy (RT) has defined a new role for RT in the treatment of both primary and metastatic liver cancer. Despite major advances in how RT is delivered, radiation-induced liver disease (RILD) remains a concern. Classic RILD, characterized by anicteric ascites and hepatomegaly, is unlikely to occur if treating to doses of ≤30Gy in 2Gy per fraction in patients with baseline Child-Pugh A liver function. On the other hand, nonclassic RILD is a spectrum of liver toxicity, including a general decline in liver function and elevation of liver enzymes...
October 2017: Seminars in Radiation Oncology
https://www.readbyqxmd.com/read/28865517/management-of-radiation-toxicity-in-head-and-neck-cancers
#14
REVIEW
Farzan Siddiqui, Benjamin Movsas
Head and neck cancers account for approximately 3% of all cancers in the United States with 62,000 new cases diagnosed annually. The global incidence is approximately 700,000 new cases a year. There has also been a recent increase in human papilloma virus-related oropharyngeal cancers. External beam radiation therapy (RT) is commonly used as an effective therapy for head and neck (H&N) cancers. This is used as a definitive treatment (alone or in combination with chemotherapy) or as an adjuvant treatment after surgical resection of the tumors...
October 2017: Seminars in Radiation Oncology
https://www.readbyqxmd.com/read/28865516/radiation-toxicity-in-the-central-nervous-system-mechanisms-and-strategies-for-injury-reduction
#15
REVIEW
DeeDee Smart
The potential for radiation-induced toxicities in the brain produces significant anxiety, both among patients receiving radiation therapy and those radiation oncologists providing treatment. These concerns often play a significant role in the medical decision-making process for most patients with diseases in which radiotherapy may be a treatment consideration. Although the precise mechanisms of neurotoxicity and neurodegeneration after ionizing radiation exposure continue to be poorly understood from a biological perspective, there is an increasing body of scientific and clinical literature that is producing a better understanding of how radiation causes brain injury; factors that determine whether toxicities occur; and potential preventative, treatment, and mitigation strategies for patients at high risk or with symptoms of injury...
October 2017: Seminars in Radiation Oncology
https://www.readbyqxmd.com/read/28865515/imaging-radiation-induced-normal-tissue-injury-to-quantify-regional-dose-response
#16
REVIEW
David V Fried, Shiva K Das, Lawrence B Marks
Noninvasive imaging has and will continue to play a pivotal role in the assessment of radiation-induced normal tissue toxicity. In this review, we will examine key literature regarding the use of anatomic and physiological imaging in relation to radiation-induced normal tissue toxicity. Additionally, this review contains a novel methodology for potentially incorporating dose-response data into treatment planning and normal tissue toxicity modeling.
October 2017: Seminars in Radiation Oncology
https://www.readbyqxmd.com/read/28865514/mechanisms-of-normal-tissue-injury-from-irradiation
#17
REVIEW
Deborah E Citrin, James B Mitchell
Normal tissue injury from irradiation is an unfortunate consequence of radiotherapy. Technologic improvements have reduced the risk of normal tissue injury; however, toxicity causing treatment breaks or long-term side effects continues to occur in a subset of patients. The molecular events that lead to normal tissue injury are complex and span a variety of biologic processes, including oxidative stress, inflammation, depletion of injured cells, senescence, and elaboration of proinflammatory and profibrogenic cytokines...
October 2017: Seminars in Radiation Oncology
https://www.readbyqxmd.com/read/28865513/functional-assays-for-individual-radiosensitivity-a-critical-review
#18
REVIEW
Mélanie L Ferlazzo, Michel Bourguignon, Nicolas Foray
A complete understanding of the mechanisms of the response to radiation would help in a better evaluation of the radiation-induced risks. To this aim, individual radiosensitivity, that is, the proneness to radiation-induced tissue reactions attributable to cell death, has been documented since the beginning of the 20th century. For several decades, developing informative predictive assays has been one of the most important challenges of radiobiologists. This article is a critical review devoted to the major functional assays to predict radiosensitivity and their strengths and weaknesses, notably those based on the quantification of clonogenic cell survival, micronuclei, p21 expression, apoptosis, chromosome and DNA repair, and signaling...
October 2017: Seminars in Radiation Oncology
https://www.readbyqxmd.com/read/28865512/radiogenomics-identification-of-genomic-predictors-for-radiation-toxicity
#19
REVIEW
Barry S Rosenstein
The overall goal of radiogenomics is the identification of genomic markers that are predictive for the development of adverse effects resulting from cancer treatment with radiation. The principal rationale for a focus on toxicity in radiogenomics is that for many patients treated with radiation, especially individuals diagnosed with early-stage cancers, the survival rates are high, and therefore a substantial number of people will live for a significant period of time beyond treatment. However, many of these patients could suffer from debilitating complications resulting from radiotherapy...
October 2017: Seminars in Radiation Oncology
https://www.readbyqxmd.com/read/28865511/introduction
#20
EDITORIAL
Deborah E Citrin
No abstract text is available yet for this article.
October 2017: Seminars in Radiation Oncology
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