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https://www.readbyqxmd.com/read/28731537/frailty-and-cancer-implications-for-oncology-surgery-medical-oncology-and-radiation-oncology
#1
REVIEW
Cecilia G Ethun, Mehmet A Bilen, Ashesh B Jani, Shishir K Maithel, Kenneth Ogan, Viraj A Master
Answer questions and earn CME/CNE The concept of frailty has become increasingly recognized as one of the most important issues in health care and health outcomes and is of particular importance in patients with cancer who are receiving treatment with surgery, chemotherapy, and radiotherapy. Because both cancer itself, as well as the therapies offered, can be significant additional stressors that challenge a patient's physiologic reserve, the incidence of frailty in older patients with cancer is especially high-it is estimated that over one-half of older patients with cancer have frailty or prefrailty...
July 21, 2017: CA: a Cancer Journal for Clinicians
https://www.readbyqxmd.com/read/28730140/current-advances-in-checkpoint-inhibitors-lessons-from-non-central-nervous-system-cancers-and-potential-for-glioblastoma
#2
REVIEW
Natasha Lakin, Robert Rulach, Stefan Nowicki, Kathreena M Kurian
The adaptive immune system depends on the sequence of antigen presentation, activation, and then inhibition to mount a proportionate response to a threat. Tumors evade the immune response partly by suppressing T-cell activity using immune checkpoints. The use of cytotoxic T-lymphocyte-associated protein 4 (CTLA-4), programmed cell death 1 (PD-1), and programmed cell death ligand 1 (PD-L1) antibodies counteract this suppression, thereby enhancing the antitumor activity of the immune system. This approach has proven efficacy in melanoma, renal cancer, and lung cancer...
2017: Frontiers in Oncology
https://www.readbyqxmd.com/read/28725253/computed-tomography-based-treatment-planning-for-high-dose-rate-brachytherapy-using-the-tandem-and-ring-applicator-influence-of-applicator-choice-on-organ-dose-and-inter-fraction-adaptive-planning
#3
REVIEW
Vishruta A Dumane, Yading Yuan, Ren-Dih Sheu, Vishal Gupta
Three dimensional planning for high-dose-rate (HDR) brachytherapy in cervical cancer has been highly recommended by consensus guidelines such as the American Brachytherapy Society (ABS) and the Groupe Européen de Curiethérapie - European Society for Radiotherapy and Oncology (GEC-ESTRO). In this document, we describe our experience with computed tomography (CT)-based planning using the tandem/ring applicator. We discuss the influence of applicator geometry on doses to organs at risk (OARs), namely the bladder, rectum, and sigmoid...
June 2017: Journal of Contemporary Brachytherapy
https://www.readbyqxmd.com/read/28724330/immunotherapy-advances-for-mesothelioma-treatment
#4
Emyr Bakker, Alice Guazzelli, Firozeh Ashtiani, Constantinos Demonacos, Marija Krstic-Demonacos, Luciano Mutti
Mesothelioma is a rare type of cancer that is strongly tied to asbestos exposure. Despite application of different modalities such as chemotherapy, radiotherapy and surgery, patient prognosis remains very poor and therapies are ineffective. Much research currently focuses on the application of novel approaches such as immunotherapy towards this disease. Areas Covered: The types, stages and aetiology of mesothelioma are detailed, followed by a discussion of the current treatment options such as radiotherapy, surgery, and chemotherapy...
July 20, 2017: Expert Review of Anticancer Therapy
https://www.readbyqxmd.com/read/28723274/identifying-voxels-at-risk-for-progression-in-glioblastoma-based-on-dosimetry-physiologic-and-metabolic-mri
#5
Mekhail Anwar, Annette M Molinaro, Olivier Morin, Susan M Chang, Daphne A Haas-Kogan, Sarah J Nelson, Janine M Lupo
Despite the longstanding role of radiation in cancer treatment and the presence of advanced, high-resolution imaging techniques, delineation of voxels at-risk for progression remains purely a geometric expansion of anatomic images, missing subclinical disease at risk for recurrence while treating potentially uninvolved tissue and increasing toxicity. This remains despite the modern ability to precisely shape radiation fields. A striking example of this is the treatment of glioblastoma, a highly infiltrative tumor that may benefit from accurate identification of subclinical disease...
July 19, 2017: Radiation Research
https://www.readbyqxmd.com/read/28714458/a-graphical-approach-to-optimizing-variable-kernel-smoothing-parameters-for-improved-deformable-registration-of-ct-and-cone-beam-ct-images
#6
Vern Hart, Damon Burrow, X Allen Li
A systematic method is presented for determining optimal parameters in variable-kernel deformable image registration of cone beam CT and CT images, in order to improve accuracy and convergence for potential use in online adaptive radiotherapy. Assessed conditions included the noise constant (symmetric force demons), the kernel reduction rate, the kernel reduction percentage, and the kernel adjustment criteria. Four such parameters were tested in conjunction with reductions of 5, 10, 15, 20, 30, and 40%. Noise constants ranged from 1...
July 17, 2017: Physics in Medicine and Biology
https://www.readbyqxmd.com/read/28714454/a-back-projection-algorithm-in-the-presence-of-an-extra-attenuating-medium-towards-epid-dosimetry-for-the-mr-linac
#7
I Torres-Xirau, I Olaciregui-Ruiz, R A Rozendaal, P González, B J Mijnheer, J-J Sonke, U A van der Heide, A Mans
In external beam radiotherapy, electronic portal imaging devices (EPIDs) are frequently used for pre-treatment and for in vivo dose verification. Currently, various MR-guided radiotherapy systems are being developed and clinically implemented. Independent dosimetric verification is highly desirable. For this purpose we adapted our EPID-based dose verification system for use with the MR-Linac combination developed by Elekta in cooperation with UMC Utrecht and Philips. In this study we extended our back-projection method to cope with the presence of an extra attenuating medium between the patient and the EPID...
July 17, 2017: Physics in Medicine and Biology
https://www.readbyqxmd.com/read/28711575/how-to-approach-a-patient-with-limited-stage-hodgkin-lymphoma-who-remains-pet-positive-at-the-end-of-chemotherapy-radiation-therapy
#8
REVIEW
Nmazuo W Ozuah, Ann S LaCasce
The use of 18-F fluorodeoxyglucose (FDG) positron emission tomography (PET) with computed tomography has emerged as a crucial tool for response-adapted therapy in Hodgkin lymphoma (HL). Although more studies have focused on the predictive value of an interim or early PET obtained after 2 cycles of chemotherapy, there are indications that the end of therapy PET might even be more predictive of outcome. The optimal treatment of patients with limited stage HL who are PET-positive after chemotherapy is unknown...
June 29, 2017: Clinical Lymphoma, Myeloma & Leukemia
https://www.readbyqxmd.com/read/28695992/optimal-radiotherapy-target-volumes-in-intracranial-nongerminomatous-germ-cell-tumors-long-term-institutional-experience-with-chemotherapy-surgery-and-dose-and-field-adapted-radiotherapy
#9
William G Breen, Miran J Blanchard, Amulya Nageswara Rao, David J Daniels, Jan C Buckner, Nadia N Issa Laack
PURPOSE: To evaluate patterns of failure after multimodality treatment of nongerminomatous germ cell tumors (NGGCTs). MATERIALS AND METHODS: We retrospectively reviewed records of 3,440 patients diagnosed with primary intracranial NGGCT between 1988 and 2014. RESULTS: Thirty-four patients received induction chemotherapy followed by radiation with or without surgery. Median follow-up was 11.1 years (0.8-23.3). Outcomes were significantly improved in these 34 patients (5-year overall survival [OS]: 88% versus 50%, P = 0...
July 11, 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/28693798/brain-metastases-from-non-small-cell-lung-carcinoma-changing-concepts-for-improving-patients-outcome
#10
REVIEW
Chloé Rancoule, Alexis Vallard, Jean-Baptiste Guy, Sophie Espenel, Peng Diao, Cyrus Chargari, Nicolas Magné
The management of Non Small Cell Lung Cancer (NSCLC) brain metastases is challenging, as this frequent complication negatively impacts patients' quality of life, and can be a life-threatening event. Through a review of the literature, we discuss the main therapeutic options and the recent developments that improved (and complicated) the management of NSCLC brain metastases patients. Most current validated approaches are local with exclusive or combined surgery, whole brain radiotherapy (WBRT) and stereotactic radiotherapy (SRT)...
August 2017: Critical Reviews in Oncology/hematology
https://www.readbyqxmd.com/read/28692129/distortion-free-diffusion-mri-using-an-mri-guided-tri-cobalt-60-radiotherapy-system-sequence-verification-and-preliminary-clinical-experience
#11
Yu Gao, Fei Han, Ziwu Zhou, Minsong Cao, Tania Kaprealian, Mitchell Kamrava, Chenyang Wang, John Neylon, Daniel A Low, Yingli Yang, Peng Hu
PURPOSE: Monitoring tumor response during the course of treatment and adaptively modifying treatment plan based on tumor biological feedback may represent a new paradigm for radiotherapy. Diffusion MRI has shown great promises in assessing and predicting tumor response to radiotherapy. However, the conventional diffusion-weighted single-shot echo-planar-imaging (DW-ssEPI) technique suffers from limited resolution, severe distortion and possibly inaccurate ADC at low field strength. The purpose of this work is to develop a reliable, accurate and distortion-free diffusion MRI technique that is practicable for longitudinal tumor response evaluation and adaptive radiotherapy on a 0...
July 10, 2017: Medical Physics
https://www.readbyqxmd.com/read/28690586/modulations-in-the-peripheral-immune-system-of-glioblastoma-patient-is-connected-to-therapy-and-tumor-progression-a-case-report-from-the-immo-glio-01-trial
#12
Paul F Rühle, Nicole Goerig, Roland Wunderlich, Rainer Fietkau, Udo S Gaipl, Annedore Strnad, Benjamin Frey
Immune responses are important for efficient tumor elimination, also in immune privileged organs such as the brain. Fostering antitumor immunity has therefore become an important challenge in cancer therapy. This cannot only be achieved by immunotherapies as already standard treatments such as radiotherapy and chemotherapy modify the immune system. Consequently, the understanding of how the tumor, the tumor microenvironment, and immune system are modulated by cancer therapy is required for prognosis, prediction, and therapy adaption...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28690126/-mri-based-radiotherapy-planning
#13
A Largent, J-C Nunes, C Lafond, N Périchon, J Castelli, Y Rolland, O Acosta, R de Crevoisier
MRI-based radiotherapy planning is a topical subject due to the introduction of a new generation of treatment machines combining a linear accelerator and a MRI. One of the issues for introducing MRI in this task is the lack of information to provide tissue density information required for dose calculation. To cope with this issue, two strategies may be distinguished from the literature. Either a synthetic CT scan is generated from the MRI to plan the dose, or a dose is generated from the MRI based on physical underpinnings...
July 6, 2017: Cancer Radiothérapie: Journal de la Société Française de Radiothérapie Oncologique
https://www.readbyqxmd.com/read/28687397/estro-acrop-consensus-guideline-on-implementation-and-practice-of-stereotactic-body-radiotherapy-for-peripherally-located-early-stage-non-small-cell-lung-cancer
#14
Matthias Guckenberger, Nicolaus Andratschke, Karin Dieckmann, Mischa S Hoogeman, Morten Hoyer, Coen Hurkmans, Stephanie Lang, Eric Lartigau, Alejandra Méndez Romero, Suresh Senan, Dirk Verellen
BACKGROUND: Stereotactic body radiotherapy (SBRT) has become the standard of care for medically inoperable patients with peripherally located, early stage non-small cell lung cancer (NSCLC), and for those refusing surgical resection. Despite the availability of national and international guidelines, there exists substantial variability in many aspects of SBRT practice. METHODS: The ESTRO ACROP guideline is based on a questionnaire covering all aspects of SBRT implementation and practice (n=114 items)...
July 4, 2017: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
https://www.readbyqxmd.com/read/28679765/sequential-tracking-of-pd-l1-expression-and-rad50-induction-in-circulating-tumor-and-stromal-cells-of-lung-cancer-patients-undergoing-radiotherapy
#15
Daniel L Adams, Diane K Adams, Jianzhong He, Neda Kalhor, Ming Zhang, Ting Xu, Hui Gao, James M Reuben, Yawei Qiao, Ritsuko Komaki, Zhongxing Liao, Martin J Edelman, Cha-Mei Tang, Steven H Lin
Evidence suggests that PD-L1 can be induced with radiotherapy and may be an immune escape mechanism in cancer. Monitoring this response is limited as repetitive biopsies during therapy is impractical, dangerous and misses tumor stromal cells. Monitoring PD-L1 expression in both circulating tumor cells (CTCs) and circulating stromal cells (CStCs) in blood based biopsies might be a practical alternative for sequential, non-invasive assessment of changes in tumor and stromal cells. <br /><br />Peripheral blood was collected before and after radiotherapy from 41 lung cancer patients, as was primary biopsies...
July 5, 2017: Clinical Cancer Research: An Official Journal of the American Association for Cancer Research
https://www.readbyqxmd.com/read/28677817/inhibition-of-the-hdac-suv39-g9a-pathway-restores-the-expression-of-dna-damage-dependent-major-histocompatibility-complex-class%C3%A2-i-related-chain%C3%A2-a%C3%A2-and%C3%A2-b-in-cancer-cells
#16
Nakako Izumi Nakajima, Atsuko Niimi, Mayu Isono, Takahiro Oike, Hiro Sato, Takashi Nakano, Atsushi Shibata
Immunotherapy is expected to be promising as a next generation cancer therapy. Immunoreceptors are often activated constitutively in cancer cells, however, such levels of ligand expression are not effectively recognized by the native immune system due to tumor microenvironmental adaptation. Studies have demonstrated that natural-killer group 2, member D (NKG2D), a major activating immunoreceptor, responds to DNA damage. The upregulation of major histocompatibility complex class I-related chain A and B (MICA/B) (members of NKG2D ligands) expression after DNA damage is associated with NK cell-mediated killing of cancer cells...
June 30, 2017: Oncology Reports
https://www.readbyqxmd.com/read/28675445/europium-155-as-a-source-for-dual-energy-cone-beam-computed-tomography-in-adaptive-proton-therapy-a-simulation-study
#17
Jiahua Zhu, Scott N Penfold
PURPOSE: To investigate the feasibility of a 3D imaging system utilizing a (155) Eu source and pixelated cadmium-zinc-telluride (CZT) detector for applications in adaptive radiotherapy. Specifically, to compare the reconstructed stopping power ratio (SPR) values of a head phantom obtained with the proposed imaging technique with theoretical SPR values. METHOD: A Geant4 Monte Carlo simulation was performed with the novel imaging system. The simulation was repeated with a typical 120 kV X-ray tube spectrum while maintaining all other parameters...
July 4, 2017: Medical Physics
https://www.readbyqxmd.com/read/28673538/tailoring-radiotherapy-according-to-cancer-subtypes
#18
Roberto Orecchia
Radiotherapy is able to improve locoregional control in breast cancer patients both after breast conserving surgery or mastectomy, with positive impact in high-risk patients for long-term survival. Recent advances in the precision of radiotherapy were based on the choice of the appropriate fractionation and technique. But the concept of adaptive radiotherapy is not only technical, and includes the biologic characterisation of the breast tumor. The knowledge that different subtypes of breast cancer can have distinct locoregional patterns of recurrence is consisted in the literature data...
June 30, 2017: Breast: Official Journal of the European Society of Mastology
https://www.readbyqxmd.com/read/28671024/prospective-pilot-study-comparing-the-need-for-adaptive-radiotherapy-in-unresected-bulky-disease-and-in-postoperative-patients-with-head-and-neck-cancer
#19
Omar Mahmoud, Isildinha M Reis, Michael M Samuels, Nagy Elsayyad, Elizabeth Bossart, Joseph Both, Ehsan ELGhoneimy, Magda Moustafa, Mohamed AbdAllah, Cristiane Takita
BACKGROUND: Adaptive radiotherapy is being used in few institutions in patients with head and neck cancer having bulky disease using periodic computed tomography imaging accounting for volumetric changes in tumor volume and/or weight loss. Limited data are available on ART in the postoperative setting. We aim to identify parameters that would predict the need for ART in patients with head and neck cancer and whether ART should be applied in postoperative setting. MATERIALS AND METHODS: Twenty patients with stage III-IV head and neck cancer were prospectively accrued...
January 1, 2017: Technology in Cancer Research & Treatment
https://www.readbyqxmd.com/read/28666551/european-organization-for-research-and-treatment-of-cancer-eortc-recommendations-for-planning-and-delivery-of-high-dose-high-precision-radiotherapy-for-lung-cancer
#20
Dirk De Ruysscher, Corinne Faivre-Finn, Ditte Moeller, Ursula Nestle, Coen W Hurkmans, Cécile Le Péchoux, José Belderbos, Matthias Guckenberger, Suresh Senan
PURPOSE: To update literature-based recommendations for techniques used in high-precision thoracic radiotherapy for lung cancer, in both routine practice and clinical trials. METHODS: A literature search was performed to identify published articles that were considered clinically relevant and practical to use. Recommendations were categorised under the following headings: patient positioning and immobilisation, Tumour and nodal changes, CT and FDG-PET imaging, target volumes definition, radiotherapy treatment planning and treatment delivery...
June 27, 2017: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
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