Personalized Radiotherapy in Cancer Care
A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Therapy".
Deadline for manuscript submissions: 15 October 2024 | Viewed by 3703
Special Issue Editors
Interests: innovative radiation oncology technologies; stereotactic radiosurgery; gamma knife; stereotactic body radiation therapy; image-guided radiation therapy; combined immunotherapy and radiotherapy
Special Issue Information
Dear Colleagues,
In 2004, the 21-gene recurrence score (RS) was established as the first predictive gene test for patients with hormonal receptor positive and HER-2 negative breast cancer who would not benefit from chemotherapy. Since then, numerous predictive biomarkers have been discovered, which has allowed us to tailor treatments to patients to offer them the best chance of survival, while also minimizing treatment-related toxicity. While many of the new predictive biomarkers involve modified systemic therapy, to the focus is now on optimizing radiation treatments. Predictive genetic tests and the presence of biomarkers are being studied to optimize radiation doses and volumes. This Special Issue hopes to highlight the current status and future plans of personalized radiation therapy for patients with cancer at different disease sites.
Prof. Dr. Bin S. Teh
Dr. Waqar M. Haque
Guest Editors
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.
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Keywords
- predictive biomarkers
- treatment-related toxicity
- radiation treatments
- radiation dose and volume
- personalized radiation therapy
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Planned Papers
The below list represents only planned manuscripts. Some of these manuscripts have not been received by the Editorial Office yet. Papers submitted to MDPI journals are subject to peer-review.
Title: Risk-Stratified Radiotherapy in Pediatric Cancer
Authors: Rituraj Upadhyay; Arnold C. Paulino
Affiliation: University of Texas MD Anderson Cancer Center
Abstract: While the cure rate of cancer in children has markedly improved in the last few decades, late effects continue to be a problem in survivors. Radiotherapy, which is a major component of treatment in many cancers, is one of the major agents responsible for late toxicity. In the past decade, radiotherapy has been omitted in patients achieving excellent response to chemotherapy such as in Hodgkin lymphoma and Wilms tumor with lung metastases. Likewise response to chemotherapy has been used to determine whether lower doses of radiation can be delivered in intracranial germinoma and pediatric nasopharyngeal carcinoma. Molecular subtyping in medulloblastoma is currently being employed and in WNT-pathway M0 tumors, reduction of radiotherapy dose to the craniospinal axis and tumor bed is currently being investigated. Finally, dose escalation is being performed in rhabdomyosarcoma > 5 cm who do not achieve a complete response to initial 9 weeks of chemotherapy to improve local control.
Title: A systematic review of phase II/III trials of hypofractionated versus conventionally fractionated radiation therapy, in stage III non-small cell lung cancer patients
Authors: May N. Tsao; Yee Ung; Patrick Cheung; Ian Poon; Alexander V. Louie
Affiliation: Odette Cancer Centre, University of Toronto
Abstract: Introduction: This systematic review evaluated whether curative intent hypofractionated radiation therapy improved survival (primary endpoint) as compared to standard conventionally fractionated radiation therapy for stage III non-small cell lung cancer (NSCLC) patients. Toxicity was also examined as a secondary endpoint.
Methods: Electronic bibliographic databases were searched from January 1,1990 to March 31, 2024. Phase II and phase III trials were included to assess survival (primary outcome) and toxicity (secondary outcome) for newly diagnosed stage III NSCLC patients.
Results: Eight phase II trials (n= 349 participants), 3 randomized phase II trials (n= 382 participants) and 5 randomized phase III trials (n= 811 participants), for a total of 1542 participants were identified. The published trials were heterogenous, with a wide variety of dose prescriptions. A wide range of survivals (median survival 13.6 months – 42.5 months) and toxicities such as grade 3 or higher esophagitis (0-42%) and grade 3 or higher pneumonitis (0-18%) were reported.
Conclusions: There is no level 1 evidence, to date that suggests that any hypofractionated regimen (dose escalated or not) improves survival as compared to conventionally fractionated radiation. The published phase III trials have been powered for superiority (not equivalence) for the hypofractionated arm. Toxicity with hypofractionated regimens may be similar to conventionally fractionated regimens when normal tissue radiotherapy constraints are kept within tolerance limits. It is unclear how the use of systemic therapy may negatively affect radiation toxicity with hypofractionated radiation therapy.