Re-Irradiation: New Challenges and Perspectives

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Methods and Technologies Development".

Deadline for manuscript submissions: closed (30 May 2024) | Viewed by 2192

Special Issue Editors


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Guest Editor
Medical Physicist Department, IRCCS Regina Elena National Cancer Institute, Rome, Italy
Interests: treatment planning; irradiation techniques; multimodality imaging; dose tolerance of tissues

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Guest Editor
Radiation Oncology Department, IRCCS Regina Elena National Cancer Institute, Rome, Italy
Interests: radiotherapy; genito-urinary cancer; head and neck cancer; radiobiology

Special Issue Information

Dear Colleagues,

In the last years, due to the prolonged survival, the number of patients that experience a recurrence or a new second cancer has been rapidly increasing. Emerging evidence from meta-analysis shows that re-irradiation is a first line option for failure after radiotherapy. Technological advances, together with new treatment modalities and fractionations, allow to manage challenging scenarios where the evaluation of therapeutic gain has to take into account the need of treating the tumor while impinging on tissues that have already been irradiated. Many aspects need to be considered; from the more clinical ones, like a true understanding of the radiobiology behind re-irradiation, to the most technical, like image registration, re-planning and dose accumulation.

This Special Issue aims to give an overview of the current strategies applied, clinical, physical and technological, together with suggesting new perspectives for the future; like fully exploiting information from multimodality imaging in the characterization of pre irradiated tissues or using the combination of different radiotherapy modalities, protons or heavy ions, or focusing on the treatment planning and delivery aspects.

We are, therefore, pleased to invite you to give your contribution with original articles and reviews that are within the scope of the journal, sharing your experience in details, also highlighting the limitations of your studies, so that the published papers can really represent an enrichment for the colleagues that are called to face similar challenges.

We look forward to receiving your contributions.

Dr. Valeria Landoni
Dr. Giuseppe Sanguineti
Guest Editors

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Keywords

  • re-irradiation 
  • radiotherapy 
  • therapeutic gain 
  • tissues tolerance to radiation 
  • image registration 
  • treatment planning 
  • dose accumulation

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Published Papers (1 paper)

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Research

13 pages, 1421 KiB  
Article
Brain Re-Irradiation Robustly Accounting for Previously Delivered Dose
by Christopher Thompson, Christopher Pagett, John Lilley, Stina Svensson, Kjell Eriksson, Rasmus Bokrantz, Jakob Ödén, Michael Nix, Louise Murray and Ane Appelt
Cancers 2023, 15(15), 3831; https://doi.org/10.3390/cancers15153831 - 28 Jul 2023
Cited by 2 | Viewed by 1693
Abstract
(1) Background: The STRIDeR (Support Tool for Re-Irradiation Decisions guided by Radiobiology) planning pathway aims to facilitate anatomically appropriate and radiobiologically meaningful re-irradiation (reRT). This work evaluated the STRIDeR pathway for robustness compared to a more conservative manual pathway. (2) Methods: For ten [...] Read more.
(1) Background: The STRIDeR (Support Tool for Re-Irradiation Decisions guided by Radiobiology) planning pathway aims to facilitate anatomically appropriate and radiobiologically meaningful re-irradiation (reRT). This work evaluated the STRIDeR pathway for robustness compared to a more conservative manual pathway. (2) Methods: For ten high-grade glioma reRT patient cases, uncertainties were applied and cumulative doses re-summed. Geometric uncertainties of 3, 6 and 9 mm were applied to the background dose, and LQ model robustness was tested using α/β variations (values 1, 2 and 5 Gy) and the linear quadratic linear (LQL) model δ variations (values 0.1 and 0.2). STRIDeR robust optimised plans, incorporating the geometric and α/β uncertainties during optimisation, were also generated. (3) Results: The STRIDeR and manual pathways both achieved clinically acceptable plans in 8/10 cases but with statistically significant improvements in the PTV D98% (p < 0.01) for STRIDeR. Geometric and LQ robustness tests showed comparable robustness within both pathways. STRIDeR plans generated to incorporate uncertainties during optimisation resulted in a superior plan robustness with a minimal impact on PTV dose benefits. (4) Conclusions: Our results indicate that STRIDeR pathway plans achieved a similar robustness to manual pathways with improved PTV doses. Geometric and LQ model uncertainties can be incorporated into the STRIDeR pathway to facilitate robust optimisation. Full article
(This article belongs to the Special Issue Re-Irradiation: New Challenges and Perspectives)
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