Recent Advances on the Role of Intensity–Modulated Radiotherapy in Cancer

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Therapy".

Deadline for manuscript submissions: 31 August 2025 | Viewed by 2387

Special Issue Editor


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Guest Editor
Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
Interests: radiology; ovarian cancer; breast cancer; diagnostic imaging; radiotherapy

Special Issue Information

Dear Colleagues,

The emergence of intensity-modulated radiotherapy (IMRT) was one of the most revolutionary events in radiation oncology in the past 20 years. It enables the optimization of doses to tumors and the sparing of normal organs with information technology. These clinical superiorities were also demonstrated in many clinical trials for various diseases. Today, IMRT is widely accepted as curative or palliative treatment and gradually replacing conventional radiotherapy worldwide. In this IMRT era, new research fields such as hypofractionation, reirradiation, and palliative stereotactic radiotherapy have been developed. Information technology, artificial intelligence, and quality control/assurance came to be the main issues in this era.

Recently, proton therapy (PT) has emerged as the next generation following IMRT. PT has a physical characteristic known as the Bragg peak, where protons deposit most of their energy over a finite range without exit dose. Despite the edge, the optimal role of PT is not as well-defined as IMRT for now. It is partially caused by the lack of enough clinical evidence that PT is superior to IMRT. If you forecast the future, IMRT may be still the main tool for most radiation oncologists in the next decade.

In this Special Issue, we aim to elucidate the role of IMRT by reviewing the literature and reporting new findings addressing some of the unanswered questions.

Dr. Taro Murai
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Cancers is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Dr. Taro Murai
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Cancers is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • intensity modulated radiotherapy
  • medical physics
  • stereotactic radiotherapy
  • proton therapy
  • artificial intelligence

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Published Papers (2 papers)

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Research

15 pages, 1847 KiB  
Article
Fractionated Stereotactic Intensity-Modulated Radiotherapy for Large Brain Metastases: Comprehensive Analyses of Dose–Volume Predictors of Radiation-Induced Brain Necrosis
by Taro Murai, Yuki Kasai, Yuta Eguchi, Seiya Takano, Nozomi Kita, Akira Torii, Taiki Takaoka, Natsuo Tomita, Yuta Shibamoto and Akio Hiwatashi
Cancers 2024, 16(19), 3327; https://doi.org/10.3390/cancers16193327 - 28 Sep 2024
Viewed by 611
Abstract
Background: The objective was to explore dosimetric predictors of brain necrosis (BN) in fractionated stereotactic radiotherapy (SRT). Methods: After excluding collinearities carefully, multivariate logistic models were developed for comprehensive analyses of dosimetric predictors in patients who received first-line fractionated SRT for brain metastases [...] Read more.
Background: The objective was to explore dosimetric predictors of brain necrosis (BN) in fractionated stereotactic radiotherapy (SRT). Methods: After excluding collinearities carefully, multivariate logistic models were developed for comprehensive analyses of dosimetric predictors in patients who received first-line fractionated SRT for brain metastases (BMs). The normal brain volume receiving an xx Gy biological dose in 2 Gy fractions (VxxEQD2) was calculated from the retrieved dose–volume parameters. Results: Thirty Gy/3 fractions (fr) SRT was delivered to 34 patients with 75 BMs (median target volume, 3.2 cc), 35 Gy/5 fr to 30 patients with 57 BMs (6.4 cc), 37.5 Gy/5 fr to 28 patients with 47 BMs (20.2 cc), and 40 Gy/10 fr to 20 patients with 37 BMs (24.3 cc), according to protocols, depending on the total target volume (p < 0.001). After excluding the three-fraction groups, the incidence of symptomatic BN was significantly higher in patients with a larger V50EQD2 (adjusted odds ratio: 1.07, p < 0.02), V55EQD2 (1.08, p < 0.01), or V60EQD2 (1.09, p < 0.01) in the remaining five- and ten-fraction groups. The incidence of BN was also significantly higher in cases with V55EQD2 > 30 cc or V60EQD2 > 20 cc (p < 0.05). These doses correspond to 28 or 30 Gy/5 fr and 37 or 40 Gy/10 fr, respectively. Conclusions: In five- or ten-fraction SRT, larger V55EQD2 or V60EQD2 are BN risk predictors. These biologically high doses may affect BN incidence. Thus, the planning target volume margin should be minimized as much as possible. Full article
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14 pages, 1375 KiB  
Article
Patterns and Incidence of Pneumonitis and Initial Treatment Outcomes with Durvalumab Consolidation Therapy after Radical Chemoradiotherapy for Stage III Non-Small Cell Lung Cancer
by Mizuki Sato, Kazumasa Odagiri, Yuya Tabuchi, Hiroaki Okamoto, Tsuneo Shimokawa, Yukiko Nakamura and Masaharu Hata
Cancers 2024, 16(6), 1162; https://doi.org/10.3390/cancers16061162 - 15 Mar 2024
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Abstract
Durvalumab consolidation after chemoradiotherapy for stage III non-small cell lung cancer (NSCLC) has become the standard of care. Single-center results were examined for treatment outcomes and patterns of pneumonitis in clinical practice. Patients with stage III NSCLC who underwent chemoradiotherapy at our institution [...] Read more.
Durvalumab consolidation after chemoradiotherapy for stage III non-small cell lung cancer (NSCLC) has become the standard of care. Single-center results were examined for treatment outcomes and patterns of pneumonitis in clinical practice. Patients with stage III NSCLC who underwent chemoradiotherapy at our institution (n = 150) were included. The patients were treated with chemoradiotherapy and durvalumab consolidation (Group D, n = 69) or chemoradiotherapy alone (Group N, n = 81). The overall survival (OS), progression-free survival (PFS), and the incidence of and risk factors for 12-month pneumonitis grade ≥ 2 (G2) were investigated. Two-year OS rates were 71.6% in Group D and 52.7% in Group N (p = 0.052). Two-year PFS rates were 43.0% in Group D and 26.5% in Group N (p = 0.010), although a propensity score matched analysis showed no significant difference. The incidence of 12-month pneumonitis ≥ G2 tended to be higher in Group D than in Group N (41.9% vs. 26.3%, p = 0.080). However, there was no difference in pneumonitis ≥ G3 rates (10.5% vs. 12.6%, p = 0.657). A multivariate analysis showed that the lung volume spared from 5 Gy (VS5) < 1800 cm3 was a risk factor for pneumonitis ≥ G2 in Group D. Durvalumab consolidation showed the potential to prolong PFS without increasing the severity of pneumonitis. Full article
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