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Cancers
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Palliative Radiotherapy for Cancer
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Palliative Radiotherapy for Cancer

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

Deadline for manuscript submissions: 30 December 2025 | Viewed by 1352

Special Issue Editor

Prof. Rebecca Wong

E-Mail Website
Guest Editor
Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, ON M5G 2M9, Canada
Interests: radiation medicine; palliation; symptom control; oligometastases; theranostics
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Radiation therapy has long been used for palliation in cancer. Traditionally, clinical practice has focused on the relief of symptoms while causing the fewest side effects and most minimal treatment burden, with an emphasis on the principle that time is precious when life is short. In modern practice, with the increasing adoption of advanced technologies, sophisticated treatment techniques such as VMAT, SBRT, SFRT are no longer restricted to the care of patients with curable cancers. While local control for metastatic lesions is not generally a care objective, defining the situations where this is  supported by the careful choice of outcome measures is required to guide modern practice. Novel applications of radiotherapy that can influence the trajectory of metastatic processes and, hence, the patients’ cancer journey and quality of life are increasingly being investigated. The rapid growth of radiotheranostics provides us with another exciting tool that is  capable of both relieving symptoms and changing the clinical course of metastatic disease. In this Special Issue, we welcome original research articles, high-quality systematic reviews and meta-analyses that will expand our understanding of how radiation therapy can improve the journeys of cancer patients and reduce their symptom burden in both the short and long term, with a strong focus on patient reported outcomes. Translational work that will support clinical studies in this field is also welcome.

Prof. Rebecca Wong
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

  • symptom relief
  • symptom control
  • radiation medicine
  • radiotheranostics
  • theranostics
  • external beam radiotherapy
  • palliation
  • oligometastases
  • oligoprogression
  • systematic reviews and meta-analyses
  • patient reported outcomes
  • abscopal effect
  • combined modality
  • education
  • clinical practice

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Published Papers (2 papers)

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Research

15 pages, 7210 KB  
Article
Diagnosis-Related Outcome Following Palliative Spatially Fractionated Radiation Therapy (Lattice) of Large Tumors
by Gabriela Studer, Tino Streller, David Jeller, Dirk Huebner, Bruno Fuchs and Christoph Glanzmann
Cancers 2025, 17(17), 2752; https://doi.org/10.3390/cancers17172752 - 23 Aug 2025
Viewed by 431
Abstract
Background: Lattice Radiation Therapy (LRT), a spatially fractionated stereotactic radiotherapy (SBRT) technique, has shown promising results in the palliative treatment of large tumors. The focus of our first analysis of 56 lesions ≥7 cm was on the extent of shrinkage following palliative LRT [...] Read more.
Background: Lattice Radiation Therapy (LRT), a spatially fractionated stereotactic radiotherapy (SBRT) technique, has shown promising results in the palliative treatment of large tumors. The focus of our first analysis of 56 lesions ≥7 cm was on the extent of shrinkage following palliative LRT (mean 50%) and assessment of its effect duration (: mean 6 months). Herewith we present an updated analysis of our single-center LRT cohort, with a focus on LRT outcome across diagnoses and applied LRT regimens. Methods: We assessed the clinical outcome following LRT in 66 patients treated for 81 lesions between 01.2022 and 05.2025. LRT protocols included simultaneous integrated boost (sib-) LRT in 49 lesions (5 × 4–5 Gy to the entire mass with sib of 9–13 Gy to lattice vertices). Alternatively mainly in pre-irradiated and/or very large lesions—a single-fraction stereotactic LRT (SBRT-LRT) of 1 × 20 Gy to vertices only was delivered to 26 lesions. In six cases with modest response to single fraction SBRT-LRT, the sib-LRT schedule was added 4–8 weeks later. Results: The median age was 68 years (18–93). Main tumor locations were abdomino-pelvic (n = 34) and thoracic (n = 17). Histopathological diagnoses included carcinoma (n = 34), sarcoma (n = 31), and melanoma (n = 16). 31% of all lesions have been previously irradiated. 73% of cases underwent concurrent or peri-LRT systemic therapy. The mean/median overall survival (OS) time of the cohort was 7.6/4.6 months (0.4–40.2), 11.9/5.8 months in 16/66 alive, and 6.4/4.3 months in deceased patients, respectively. 82% of symptomatic patients reported immediate subjective improvement (PROM), with a lifelong response duration in most cases. Progressive disease (PD: >10% increase in initial volume) was found in 9%, stable disease (SD +/−10% of initial volume) in 19% of scanned lesions, and shrinkage (>10% reduction in initial volume) in 75%, with a mean/median tumor volume reduction of 51/60%. The extent of shrinkage was found to be 11–30%/31–60%/61–100% in 38/24/38% of lesions. Response rates (PD, SD, shrinkage) following the two applied LRT regimens, as well as those related to sarcoma and carcinoma diagnoses, were found to be comparable. Treatment tolerance was excellent (G0-1). Conclusions: Palliative LRT provides rapid subjective relief in ~80% of symptomatic patients. Radiologic shrinkage was stated in 75% of FU-scanned lesions, with a lifelong effect duration in most patients. LRT was found effective across histologies, with a similar extent of shrinkage in carcinoma and sarcoma following 1F SBRT- and 5F sib-LRT regimens, respectively. Full article
(This article belongs to the Special Issue Palliative Radiotherapy for Cancer)
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14 pages, 1032 KB  
Article
Accelerated Radiotherapy for Complicated Bone Metastases: SHARON Bone Randomized Phase III Trial Shows Non-Inferiority Compared to Standard Palliative Fractionation (NCT03503682)
by Alice Zamagni, Giambattista Siepe, Dino Gibertoni, Costanza M. Donati, Francesco Cellini, Francesco Fiorica, Donato Pezzulla, Francesco Deodato, Filippo Candoli, Silvia Bisello, Erica Scirocco, Stefania Manfrida, Milena Gabbani, Savino Cilla, Gabriella Macchia and Alessio G. Morganti
Cancers 2025, 17(12), 2000; https://doi.org/10.3390/cancers17122000 - 16 Jun 2025
Viewed by 562
Abstract
Objective: The SHARON (Short course RadiatiON therapy for palliative treatment) Bone trial is a phase III randomized non-inferiority multicentric study comparing symptom relief for complicated bone metastases (BMs) achieved through hypofractionated accelerated palliative radiotherapy (RT) to a standard RT regimen. Methods: Eligible [...] Read more.
Objective: The SHARON (Short course RadiatiON therapy for palliative treatment) Bone trial is a phase III randomized non-inferiority multicentric study comparing symptom relief for complicated bone metastases (BMs) achieved through hypofractionated accelerated palliative radiotherapy (RT) to a standard RT regimen. Methods: Eligible participants were adults with ECOG PS ≤ 3 who were referred for palliative RT for painful BMs. Patients were assigned to receive either 30 Gy delivered in 10 daily fractions or 20 Gy in 4 fractions over two consecutive days. The primary outcome was pain relief one month post-treatment. Pain relief and adverse events were also evaluated at 2, 3, 6, and 12 months after RT. This trial was registered at clinicaltrials.gov (NCT03503682). Results: Between February 2018 and November 2021, 83 patients were enrolled (30 Gy: 41; 20 Gy: 42). In the standard RT group, five patients did not complete the prescribed RT, while none in the experimental arm discontinued treatment (p = 0.026). Due to early mortality, the primary endpoint was evaluable in 73 patients (35 and 38 in the standard and experimental arms, respectively). The rate of complete pain response at one month was 22.9% and 28.9% in the 30 Gy and 20 Gy arms, respectively (p: 0.571). The overall pain response rates, which included complete and partial responses, were 74.3% and 78.9% in the 30 Gy and 20 Gy arms, respectively (p = 0.638), when considering at least a 2-point reduction in the numerical rating scale. In both arms, 4.8% of patients experienced Grade >2 toxicity. Conclusions: Administering 20 Gy in four fractions twice a day is non-inferior to the standard 30 Gy delivered in 10 fractions for pain relief in the context of complicated BMs. Furthermore, this regimen demonstrated comparable safety in terms of acute toxicity, with a lower incidence of definitive interruptions of radiotherapy. Full article
(This article belongs to the Special Issue Palliative Radiotherapy for Cancer)
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