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Cancers
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Preoperative Radiotherapy in Cancers
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Preoperative Radiotherapy in Cancers

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

Deadline for manuscript submissions: closed (30 April 2023) | Viewed by 12994

Special Issue Editor

Dr. Christiane Matuschek

E-Mail Website
Guest Editor
Department of Radiation Oncology, Heinrich Heine University, 40225 Dusseldorf, Germany
Interests: breast cancer; stereotactic radiotherapy; intraoperative radiotherapy; radiotherapy for pediatric patients; radiotherapy for elderly patients
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Today, preoperative radiotherapy is the standard of care in several tumor entities, as its superiority has been shown in randomized trials in the past.

In advanced rectal cancer, neoadjuvant radiochemotherapy achieves significantly better local control and functional outcomes than postoperative radiochemotherapy.

In soft tissue sarcomas, preoperative radiotherapy of 50 Gy in 25 fractions was equivalent in terms of local tumor control to a 32% higher dose (66 Gy in 33 fractions) of postoperative radiotherapy. There was less late radiation-induced tissue fibrosis after preoperative radiotherapy and the overall survival was significantly improved.

In Stage III NSCLC, preoperative radiochemotherapy (45 Gy, 1.5 Gy BID in 3 weeks) is equivalent to postoperative radiochemotherapy (54 Gy, 1.8 Gy in 6 weeks). Nonetheless, DFS and overall survival were superior in the preoperative arm in patients who underwent surgical resection.

In breast cancer, preoperative radiotherapy has yet to be established.

Applying adjuvant radiotherapy reduces ipsilateral breast recurrences, breast-cancer-specific mortality, and overall mortality significantly. The same advantages can be expected when applying preoperative irradiation. Administering radiotherapy preoperatively would definitely improve the cosmetic outcome in patients undergoing partial mastectomy or mastectomy with immediate reconstruction with autologous flabs. Shrinkage and fibrosis of the flab can be expected to be significantly lower compared with flabs receiving postoperative radiotherapy, as they are not irradiated.

In all cancers, the target volume can be defined more accurately in the preoperative setting than in the postoperative setting after tumor removal.

This Special issue will focus on preoperative radiotherapy in different cancers concerning oncologic endpoints, acute and late side effects, and quality of life.

Dr. Christiane Matuschek
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

  • breast cancer
  • radiotherapy
  • preoperative radiotherapy
  • meta-analysis

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Published Papers (4 papers)

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Research

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20 pages, 4459 KiB  
Article
IR-Surviving NSCLC Cells Exhibit Different Patterns of Molecular and Cellular Reactions Relating to the Multifraction Irradiation Regimen and p53-Family Proteins Expression
by Lina Alhaddad, Margarita Pustovalova, Taisia Blokhina, Roman Chuprov-Netochin, Andreyan N. Osipov and Sergey Leonov
Cancers 2021, 13(11), 2669; https://doi.org/10.3390/cancers13112669 - 28 May 2021
Cited by 11 | Viewed by 2684
Abstract
Radiotherapy is a primary treatment modality for patients with unresectable non-small cell lung cancer (NSCLC). Tumor heterogeneity still poses the central question of cancer radioresistance, whether the presence of a particular cell population inside a tumor undergoing a selective outgrowth during radio- and [...] Read more.
Radiotherapy is a primary treatment modality for patients with unresectable non-small cell lung cancer (NSCLC). Tumor heterogeneity still poses the central question of cancer radioresistance, whether the presence of a particular cell population inside a tumor undergoing a selective outgrowth during radio- and chemotherapy give rise to metastasis and tumor recurrence. In this study, we examined the impact of two different multifraction X-ray radiation exposure (MFR) regimens, fraction dose escalation (FDE) in the split course and the conventional hypofractionation (HF), on the phenotypic and molecular signatures of four MFR-surviving NSCLC cell sublines derived from parental A549 (p53 wild-type) and H1299 (p53-null) cells, namely A549FR/A549HR, H1299FR/H1299HR cells. We demonstrate that sublines surviving different MFR regimens in a total dose of 60 Gy significantly diverge in their molecular traits related to irradiation regimen and p53 status. The observed changes regarding radiosensitivity, transformation, proliferation, metabolic activity, partial epithelial-to-mesenchymal transition (EMT) program activation and 1D confined migratory behavior (wound healing). For the first time, we demonstrated that MFR exposure led to the significant decrease in the expression of p63 and p73, the p53-family members, in p53null cells, which correlated with the increase in cell polyploidy. We could not find significant differences in FRA1 expression between parental cells and their sublines that survived after any MFR regimen regardless of p53 status. In our study, the FDE regimen probably causes partial EMT program activation in MFR-survived NSCLC cells through either Vimentin upregulation in p53null or an aberrant N-cadherin upregulation in p53wt cells. The HF regimen likely less influences the EMT activation irrespectively of the p53 status of MFR-survived NSCLC cells. Our data highlight that both MFR regimens caused overall higher cell transformation of p53null H1299FR and H1299HR cells than their parental H1299 cells. Moreover, our results indicate that the FDE regimen raised the radioresistance and transformation of MFR-surviving NSCLC cells irrespectively of their p53 status, though the HF regimen demonstrated a similar effect on p53null NSCLC cells only. Our data once again emphasize that NSCLC therapy approaches should become more personalized according to radiation therapy (RT) regimen, tumor histology, and molecular status of critical proteins. Full article
(This article belongs to the Special Issue Preoperative Radiotherapy in Cancers)
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19 pages, 718 KiB  
Article
Multi-View Data Integration Methods for Radiotherapy Structure Name Standardization
by Khajamoinuddin Syed, William C. Sleeman IV, Michael Hagan, Jatinder Palta, Rishabh Kapoor and Preetam Ghosh
Cancers 2021, 13(8), 1796; https://doi.org/10.3390/cancers13081796 - 9 Apr 2021
Cited by 6 | Viewed by 2363
Abstract
Standardization of radiotherapy structure names is essential for developing data-driven personalized radiotherapy treatment plans. Different types of data are associated with radiotherapy structures, such as the physician-given text labels, geometric (image) data, and Dose-Volume Histograms (DVH). Prior work on structure name standardization used [...] Read more.
Standardization of radiotherapy structure names is essential for developing data-driven personalized radiotherapy treatment plans. Different types of data are associated with radiotherapy structures, such as the physician-given text labels, geometric (image) data, and Dose-Volume Histograms (DVH). Prior work on structure name standardization used just one type of data. We present novel approaches to integrate complementary types (views) of structure data to build better-performing machine learning models. We present two methods, namely (a) intermediate integration and (b) late integration, to combine physician-given textual structure name features and geometric information of structures. The dataset consisted of 709 prostate cancer and 752 lung cancer patients across 40 radiotherapy centers administered by the U.S. Veterans Health Administration (VA) and the Department of Radiation Oncology, Virginia Commonwealth University (VCU). We used randomly selected data from 30 centers for training and ten centers for testing. We also used the VCU data for testing. We observed that the intermediate integration approach outperformed the models with a single view of the dataset, while late integration showed comparable performance with single-view results. Thus, we demonstrate that combining different views (types of data) helps build better models for structure name standardization to enable big data analytics in radiation oncology. Full article
(This article belongs to the Special Issue Preoperative Radiotherapy in Cancers)
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Review

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25 pages, 1617 KiB  
Review
The Promise of Nanoparticles-Based Radiotherapy in Cancer Treatment
by Munima Haque, Md Salman Shakil and Kazi Mustafa Mahmud
Cancers 2023, 15(6), 1892; https://doi.org/10.3390/cancers15061892 - 22 Mar 2023
Cited by 19 | Viewed by 3833
Abstract
Radiation has been utilized for a long time for the treatment of cancer patients. However, radiotherapy (RT) has many constraints, among which non-selectivity is the primary one. The implementation of nanoparticles (NPs) with RT not only localizes radiation in targeted tissue but also [...] Read more.
Radiation has been utilized for a long time for the treatment of cancer patients. However, radiotherapy (RT) has many constraints, among which non-selectivity is the primary one. The implementation of nanoparticles (NPs) with RT not only localizes radiation in targeted tissue but also provides significant tumoricidal effect(s) compared to radiation alone. NPs can be functionalized with both biomolecules and therapeutic agents, and their combination significantly reduces the side effects of RT. NP-based RT destroys cancer cells through multiple mechanisms, including ROS generation, which in turn damages DNA and other cellular organelles, inhibiting of the DNA double-strand damage-repair system, obstructing of the cell cycle, regulating of the tumor microenvironment, and killing of cancer stem cells. Furthermore, such combined treatments overcome radioresistance and drug resistance to chemotherapy. Additionally, NP-based RT in combined treatments have shown synergistic therapeutic benefit(s) and enhanced the therapeutic window. Furthermore, a combination of phototherapy, i.e., photodynamic therapy and photothermal therapy with NP-based RT, not only reduces phototoxicity but also offers excellent therapeutic benefits. Moreover, using NPs with RT has shown promise in cancer treatment and shown excellent therapeutic outcomes in clinical trials. Therefore, extensive research in this field will pave the way toward improved RT in cancer treatment. Full article
(This article belongs to the Special Issue Preoperative Radiotherapy in Cancers)
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12 pages, 720 KiB  
Review
Oncologic Impact and Safety of Pre-Operative Radiotherapy in Localized Prostate and Bladder Cancer: A Comprehensive Review from the Cancerology Committee of the Association Française d’Urologie
by Paul Sargos, Stéphane Supiot, Gilles Créhange, Gaëlle Fromont-Hankard, Eric Barret, Jean-Baptiste Beauval, Laurent Brureau, Charles Dariane, Gaëlle Fiard, Mathieu Gauthé, Romain Mathieu, Guilhem Roubaud, Alain Ruffion, Raphaële Renard-Penna, Yann Neuzillet, Morgan Rouprêt and Guillaume Ploussard
Cancers 2021, 13(23), 6070; https://doi.org/10.3390/cancers13236070 - 2 Dec 2021
Cited by 4 | Viewed by 2871
Abstract
Preoperative radiotherapy (RT) is commonly used for the treatment of various malignancies, including sarcomas, rectal, and gynaecological cancers, but it is preferentially used as a competitive treatment to radical surgery in uro-oncology or as a salvage procedure in cases of local recurrence. Nevertheless, [...] Read more.
Preoperative radiotherapy (RT) is commonly used for the treatment of various malignancies, including sarcomas, rectal, and gynaecological cancers, but it is preferentially used as a competitive treatment to radical surgery in uro-oncology or as a salvage procedure in cases of local recurrence. Nevertheless, preoperative RT represents an attractive strategy to prevent from intraoperative tumor seeding in the operative field, to sterilize microscopic extension outside the organ, and to enhance the pathological and/or imaging tumor response rate. Several clinical works support this research field in uro-oncology. In this review article, we summarized the oncologic impact and safety of preoperative RT in localized prostate and muscle-invasive bladder cancer. Preliminary studies suggest that both modalities can be complementary as initial primary tumor treatments and that a pre-operative radiotherapy strategy could be beneficial in a well-defined population of patients who are at a very high-risk of local relapse. Future prospective trials are warranted to evaluate the oncologic benefit of such a combination of local treatments in addition to new life-prolonging systemic therapies, such as immunotherapy, and new generation hormone therapies. Moreover, the safety and the feasibility of salvage surgical procedures due to non-response or local recurrence after pelvic RT remain poorly evaluated in that context. Full article
(This article belongs to the Special Issue Preoperative Radiotherapy in Cancers)
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