Nondosimetric Risk Factors for Radiation-Induced Lung Toxicity
The decision to administer a radical course of radiotherapy (RT) is largely influenced by the dose-volume metrics of the treatment plan, but what are the patient-related and other factors that may independently increase the risk of radiation lung toxicity? Poor pulmonary function has been regarded as a risk factor and a relative contraindication for patients undergoing radical RT, but recent evidence suggests that patients with poor spirometry results may tolerate conventional or high-dose RT as well as, if not better than, patients with normal function. (Source: Seminars in Radiation Oncology)
Source: Seminars in Radiation Oncology - March 14, 2015 Category: Cancer & Oncology Authors: Feng-Ming (Spring) Kong, Shulian Wang Source Type: research
Erratum to “New Considerations in Radiation Treatment Planning for Brain Tumors: Neural Progenitor Cell-Containing Niches” Semin Radiat Oncol 24:265-272, 2014
Figure 1 in the above-referenced article was published without an acknowledgment in error. The figure should have been credited as follows: © 2006 MediVisuals Inc. Reprinted with permission from Barani IJ, Benedict SH, Lin PS, “Neural stem cells: implications for the conventional radiotherapy of central nervous system malignancies,” Int J Radiat Oncol Biol Phys 68(2):324-333, 2007. We regret the omission. (Source: Seminars in Radiation Oncology)
Source: Seminars in Radiation Oncology - March 14, 2015 Category: Cancer & Oncology Authors: Carmen Kut, Kristin Janson Redmond Source Type: research
Curing Non–Small Cell Lung Cancer With Radiotherapy: No Longer an Oxymoron
A quarter of a century has now elapsed since Johnson et al1 published an article with the dispiriting title “Thoracic radiotherapy does not prolong survival in patients with locally advanced, unresectable non–small cell lung cancer.” This was a report of a randomized trial comparing “modern megavoltage radiotherapy” (60Gy in 30 fractions) vs the same radiotherapy plus vindesine vs vindesine alone. The results were indeed disappointing, with median survivals of 8.6, 9.4, and 10.1 months and 5-year survivals of 3%, 3%, and 1% in the 3 arms. (Source: Seminars in Radiation Oncology)
Source: Seminars in Radiation Oncology - March 14, 2015 Category: Cancer & Oncology Authors: David Ball Source Type: research
Molecular Determinants of Radiation Response in Non–Small Cell Lung Cancer
Non–small cell lung cancers are now recognized to contain considerable heterogeneity and molecular diversity. Substantial progress has been made regarding molecular determinants of response to targeted agents in advanced lung cancer, and recent findings have revealed subsets of patients with driver mutations that respond rapidly to selective inhibitors. In addition, new approaches to disrupting DNA repair and inflammation and activation of the immune system are being explored. A key question in the field is whether therapeutic multimodality options incorporating radiation therapy can capitalize on the gains made in syste...
Source: Seminars in Radiation Oncology - March 14, 2015 Category: Cancer & Oncology Authors: Sue S. Yom, Maximilian Diehn, David Raben Source Type: research
Introduction
This issue of Seminars in Radiation Oncology focuses on the emerging research that encompasses the effects of ionizing radiation (IR) on the immune system. Although the finding that the degree of immunocompetence of the host influenced the response to radiotherapy dates back 35 years,1 it is only in the past 10 years that investigators have concentrated on studying the mechanisms behind these effects of radiation. (Source: Seminars in Radiation Oncology)
Source: Seminars in Radiation Oncology - December 5, 2014 Category: Cancer & Oncology Authors: Silvia C. Formenti Source Type: research
Combination Regimens of Radiation Therapy and Therapeutic Cancer Vaccines: Mechanisms and Opportunities
Radiation therapy (RT) is widely used with curative or palliative intent in the clinical management of multiple cancers. Although mainly aimed at direct tumor cell killing, mounting evidence suggests that radiation can alter the tumor to become an immunostimulatory milieu. Data suggest that the immunogenic effects of radiation can be exploited to promote synergistic antitumor effects in combination with immunotherapeutic agents. We review concepts associated with the immunogenic consequences of RT and highlight how preclinical findings are translating into clinical benefit for patients receiving combination regimens of RT ...
Source: Seminars in Radiation Oncology - December 5, 2014 Category: Cancer & Oncology Authors: Charlie Garnett-Benson, James W. Hodge, Sofia R. Gameiro Source Type: research
Current Clinical Trials Testing Combinations of Immunotherapy and Radiation
Preclinical evidence of successful combinations of ionizing radiation with immunotherapy has inspired testing the translation of these results to the clinic. Interestingly, the preclinical work has consistently predicted the responses encountered in clinical trials. The first example came from a proof-of-principle trial started in 2001 that tested the concept that growth factors acting on antigen-presenting cells improve presentation of tumor antigens released by radiation and induce an abscopal effect. (Source: Seminars in Radiation Oncology)
Source: Seminars in Radiation Oncology - December 5, 2014 Category: Cancer & Oncology Authors: Marka Crittenden, Holbrook Kohrt, Ronald Levy, Jennifer Jones, Kevin Camphausen, Adam Dicker, Sandra Demaria, Silvia Formenti Source Type: research
Combination of Radiotherapy and Immune Checkpoint Inhibitors
The ability of ionizing radiation to cause cell death and inflammatory reactions has been known since the beginning of its therapeutic use in oncology. However, only recently this property of radiation has attracted the attention of immunologists seeking to induce or improve antitumor immunity. As immune checkpoint inhibitors are becoming mainstream cancer treatments, radiation oncologists have begun to observe unexpected out-of-the-field (abscopal) responses in patients receiving radiation therapy during immunotherapy. (Source: Seminars in Radiation Oncology)
Source: Seminars in Radiation Oncology - December 5, 2014 Category: Cancer & Oncology Authors: Karsten A. Pilones, Claire Vanpouille-Box, Sandra Demaria Source Type: research
Radiotherapy and Immunogenic Cell Death
Advances in understanding the mechanisms that underlie the interplay between radiation-invoked immune responses and tumor regression are underway. Emerging applications of local radiotherapy as an immunologic adjuvant have provided radiation oncologists with a method for converting malignant cells into endogenous anticancer vaccines. The dispersion of radiotherapy-induced immune-stimulating tumor antigens released from dying tumor cells into the surrounding milieu (known as immunogenic cell death, Fig. (Source: Seminars in Radiation Oncology)
Source: Seminars in Radiation Oncology - December 5, 2014 Category: Cancer & Oncology Authors: Encouse B. Golden, Lionel Apetoh Source Type: research
Radiotherapy and Toll-Like Receptor Agonists
The clinical successes of CTLA4 and PD-1 immune checkpoint blockade in aggressive malignancies such as metastatic melanoma and non–small cell lung carcinoma inaugurate a new era in oncology. Indeed, as opposed to tumor-targeted therapies, it is now clear that immune-targeted therapies designed to enhance the antitumor immune response are a relevant strategy to obtain long-term tumor responses. Interestingly, the study of tumor cell death biology has recently revealed that part of radiotherapy efficacy relies on its ability to trigger an immune response against tumor cells. (Source: Seminars in Radiation Oncology)
Source: Seminars in Radiation Oncology - December 5, 2014 Category: Cancer & Oncology Authors: Aurelien Marabelle, Alex Filatenkov, Idit Sagiv-Barfi, Holbrook Kohrt Source Type: research
Radiation and Inflammation
The immune system has the power to modulate the expression of radiation-induced normal and tumor tissue damage. On the one hand, it can contribute to cancer cure, and on the other hand, it can influence acute and late radiation side effects, which in many ways resemble acute and chronic inflammatory disease states. The way radiation-induced inflammation feeds into adaptive antigen-specific immune responses adds another dimension to the tumor-host cross talk during radiation therapy and to possible radiation-driven autoimmune responses. (Source: Seminars in Radiation Oncology)
Source: Seminars in Radiation Oncology - December 5, 2014 Category: Cancer & Oncology Authors: Dörthe Schaue, Ewa D. Micewicz, Josephine A. Ratikan, Michael W. Xie, Genhong Cheng, William H. McBride Source Type: research
Myeloid-Derived Cells in Tumors: Effects of Radiation
The discrepancy between the in vitro and in vivo response to radiation is readily explained by the fact that tumors do not exist independently of the host organism; cancer cells grow in the context of a complex microenvironment composed of stromal cells, vasculature, and elements of the immune system. As the antitumor effect of radiotherapy depends in part on the immune system, and myeloid-derived cells in the tumor microenvironment modulate the immune response to tumors, it follows that understanding the effect of radiation on myeloid cells in the tumor is likely to be essential for comprehending the antitumor effects of ...
Source: Seminars in Radiation Oncology - December 5, 2014 Category: Cancer & Oncology Authors: Ralph E. Vatner, Silvia C. Formenti Source Type: research
The Immunology of Ablative Radiation
Radiation has been a staple of cancer therapy since the early 20th century and is implemented in nearly half of current cancer treatment plans. Originally, the genotoxic function of radiation led to a focus on damage and repair pathways associated with deoxyribonucleic acid as important therapeutic targets to augment radiation efficacy. However, in recent decades, the participation of endogenous immune responses in modifying radiation effects have been widely documented and exploited in both preclinical and clinical settings. (Source: Seminars in Radiation Oncology)
Source: Seminars in Radiation Oncology - December 5, 2014 Category: Cancer & Oncology Authors: Byron Burnette, Ralph R. Weichselbaum Source Type: research
Recurrent Malignant Gliomas
Abstract: In almost all patients, malignant glioma recurs following initial treatment with maximal safe resection, conformal radiotherapy, and temozolomide. This review describes the many options for treatment of recurrent malignant gliomas, including reoperation, alternating electric field therapy, chemotherapy, stereotactic radiotherapy or radiosurgery, or some combination of these modalities, presenting the evidence for each approach. No standard of care has been established, though the antiangiogenic agent, bevacizumab; stereotactic radiotherapy or radiosurgery; and, perhaps, combined treatment with these 2 modalities ...
Source: Seminars in Radiation Oncology - September 15, 2014 Category: Cancer & Oncology Authors: John P. Kirkpatrick, John H. Sampson Source Type: research
Management of High-Grade Gliomas in the Elderly
The incidence of glioblastoma (GBM) has been increasing over the past several decades with majority of this increase occurring in patients older than 70 years. In spite of the growing body of evidence in this area, it is still unclear as to the optimal management of elderly patients with GBM. The elderly are a heterogeneous population with a range of comorbid conditions, and functional, cognitive, and physiological changes, and ideally treatment decisions should be made in the context of a comprehensive geriatric assessment. Patients with a poor performance status or assessed as “frail” might be considered for less agg...
Source: Seminars in Radiation Oncology - September 15, 2014 Category: Cancer & Oncology Authors: Michelle Ferguson, George Rodrigues, Jeffrey Cao, Glenn Bauman Source Type: research
