Incorporating Imaging Into the Locoregional Management of Breast Cancer
Although some breast cancers present as palpable masses or with other clinical findings, many are detected at screening. Most screening is currently done with digital mammography, but high-risk patients or those with dense breast tissue may undergo additional screening examinations with magnetic resonance imaging or ultrasound. Additionally, digital breast tomosynthesis, contrast-enhanced mammography, and molecular breast imaging are newer technologies available at some sites. Optimal usage of breast imaging technologies remains controversial, both in screening and diagnostic settings following a new diagnosis of breast ca...
Source: Seminars in Radiation Oncology - November 28, 2015 Category: Cancer & Oncology Authors: Ana P. Lourenco, Martha B. Mainiero Source Type: research
New Insights into the Surgical Management of Breast Cancer
William Halstead is considered by many as the father of modern breast surgery. He popularized the notion that breast cancer progresses in an orderly fashion and that appropriately timed radical surgery can interrupt this progression to save lives. This view dominated for nearly 100 years and still persists to one extent or another in the minds of physicians and patients alike. Rapid advances in breast cancer biology have highlighted the heterogeneity of breast cancer and paradigm-shifting clinical trials have successfully challenged prevailing wisdom to effect a seed change in breast cancer surgery. (Source: Seminars in Radiation Oncology)
Source: Seminars in Radiation Oncology - November 28, 2015 Category: Cancer & Oncology Authors: David M. Euhus Source Type: research
Predicting Radiotherapy Responses and Treatment Outcomes Through Analysis of Circulating Tumor DNA
Tumors continually shed DNA into the blood where it can be detected as circulating tumor DNA (ctDNA). Although this phenomenon has been recognized for decades, techniques that are sensitive and specific enough to robustly detect ctDNA have only become available recently. Quantification of ctDNA represents a new approach for cancer detection and disease burden quantification that has the potential to revolutionize response assessment and personalized treatment in radiation oncology. Analysis of ctDNA has many potential applications, including detection of minimal residual disease following radiotherapy, noninvasive tumor ge...
Source: Seminars in Radiation Oncology - September 15, 2015 Category: Cancer & Oncology Authors: Aadel A. Chaudhuri, Michael S. Binkley, Evan C. Osmundson, Ash A. Alizadeh, Maximilian Diehn Source Type: research
Quantitative Imaging in Radiation Oncology: An Emerging Science and Clinical Service
Radiation oncology has long required quantitative imaging approaches for the safe and effective delivery of radiation therapy. The past 10 years has seen a remarkable expansion in the variety of novel imaging signals and analyses that are starting to contribute to the prescription and design of the radiation treatment plan. These include a rapid increase in the use of magnetic resonance imaging, development of contrast-enhanced imaging techniques, integration of fluorinated deoxyglucose–positron emission tomography, evaluation of hypoxia imaging techniques, and numerous others. (Source: Seminars in Radiation Oncology)
Source: Seminars in Radiation Oncology - September 15, 2015 Category: Cancer & Oncology Authors: David Anthony Jaffray, Caroline Chung, Catherine Coolens, Warren Foltz, Harald Keller, Cynthia Menard, Michael Milosevic, Julia Publicover, Ivan Yeung Source Type: research
Radiotherapy in the Era of Precision Medicine
Current predictors of radiation response are largely limited to clinical and histopathologic parameters, and extensive systematic analyses of the correlation between radiation sensitivity and genomic parameters remain lacking. In the era of precision medicine, the lack of -omic determinants of radiation response has hindered the personalization of radiation delivery to the unique characteristics of each patient׳s cancer and impeded the discovery of new therapies that can be administered concurrently with radiation therapy. (Source: Seminars in Radiation Oncology)
Source: Seminars in Radiation Oncology - September 15, 2015 Category: Cancer & Oncology Authors: Brian Yard, Eui Kyu Chie, Drew J. Adams, Craig Peacock, Mohamed E. Abazeed Source Type: research
Hypoxia and Predicting Radiation Response
The results from many studies indicate that most solid tumors, regardless of site of origin, contain hypoxic regions. Experimental studies have demonstrated that, apart from the well-known protective effect of hypoxia on the radiation response of cells and tissues, hypoxic conditions can also result in modified gene expression patterns, causing (to a greater or lesser extent in different cell populations) genomic instability, increased invasive capacity, higher propensity to metastasize, enhanced stem cell properties, and ability to survive nutrient deprivation. (Source: Seminars in Radiation Oncology)
Source: Seminars in Radiation Oncology - September 15, 2015 Category: Cancer & Oncology Authors: Richard P. Hill, Robert G. Bristow, Anthony Fyles, Marianne Koritzinsky, Michael Milosevic, Bradly G. Wouters Source Type: research
Tailoring Adjuvant Radiation Therapy by Intraoperative Imaging to Detect Residual Cancer
For many solid cancers, radiation therapy is offered as an adjuvant to surgical resection to lower rates of local recurrence and improve survival. However, a subset of patients treated with surgery alone will not have a local recurrence. Currently, there is no way to accurately determine which patients have microscopic residual disease in the tumor bed after surgery and therefore are most likely to benefit from adjuvant radiation therapy. To address this problem, a number of technologies have been developed to try to improve margin assessment of resected tissue and to detect residual cancer in the tumor bed. (Source: Semin...
Source: Seminars in Radiation Oncology - September 15, 2015 Category: Cancer & Oncology Authors: Melodi J. Whitley, Ralph Weissleder, David G. Kirsch Source Type: research
The Prediction of Radiotherapy Toxicity Using Single Nucleotide Polymorphism−Based Models: A Step Toward Prevention
Radiotherapy is a mainstay of cancer treatment, used in either a curative or palliative manner to treat approximately 50% of patients with cancer. Normal tissue toxicity limits the doses used in standard radiation therapy protocols and impedes improvements in radiotherapy efficacy. Damage to surrounding normal tissues can produce reactions ranging from bothersome symptoms that negatively affect quality of life to severe life-threatening complications. Improved ways of predicting, before treatment, the risk for development of normal tissue toxicity may allow for more personalized treatment and reduce the incidence and sever...
Source: Seminars in Radiation Oncology - September 15, 2015 Category: Cancer & Oncology Authors: Sarah L. Kerns, Suman Kundu, Jung Hun Oh, Sandeep K. Singhal, Michelle Janelsins, Lois B. Travis, Joseph O. Deasy, A. Cecile J.E. Janssens, Harry Ostrer, Matthew Parliament, Nawaid Usmani, Barry S. Rosenstein Source Type: research
DNA Damage Response Assessments in Human Tumor Samples Provide Functional Biomarkers of Radiosensitivity
Predictive biomarkers are urgently needed for individualization of radiation therapy and treatment with radiosensitizing anticancer agents. Genomic profiling of human cancers provides us with unprecedented insight into the mutational landscape of genes directly or indirectly involved in the response to radiation-induced DNA damage. However, to what extent this wealth of structural information about the cancer genome produces biomarkers of sensitivity to radiation remains to be seen. Investigators are increasingly studying the subnuclear accumulation (ie, foci) of proteins in the DNA damage response (DDR), such as gamma-H2A...
Source: Seminars in Radiation Oncology - September 15, 2015 Category: Cancer & Oncology Authors: Henning Willers, Liliana Gheorghiu, Qi Liu, Jason A. Efstathiou, Lori J. Wirth, Mechthild Krause, Cläre von Neubeck Source Type: research
Patient-Derived Xenografts as a Model System for Radiation Research
The cancer literature is filled with promising preclinical studies demonstrating impressive efficacy for new therapeutics, yet translation of these approaches into clinical successes has been rare, indicating that current methods used to predict efficacy are suboptimal. The most likely reason for the limitation of these studies is the disconnect between preclinical models and cancers treated in the clinic. Specifically, most preclinical models are poor representations of human disease. Immortalized cancer cell lines that dominate the cancer literature may be, in a sense, “paper tigers” that have been selected by decade...
Source: Seminars in Radiation Oncology - September 15, 2015 Category: Cancer & Oncology Authors: Christopher D. Willey, Ashley N. Gilbert, Joshua C. Anderson, George Yancey Gillespie Source Type: research
Breast Cancer Stem Cell Correlates as Predicative Factors for Radiation Therapy
In today׳s era of personalized medicine, the use of radiation therapy for breast cancer is still tailored to the type of surgery and the stage of the cancer. The future of breast radiation oncology would hopefully entail selecting patients for whom there is a clear benefit for the use of radiation therapy. To get to this point we need reliable predictors of radiation response. Cancer stem cells have been correlated to radiation resistance and outcome for patients with breast cancer, and there is considerable interest in whether cancer stem cell markers or biologic surrogates may be predictive of response to radiation ther...
Source: Seminars in Radiation Oncology - September 15, 2015 Category: Cancer & Oncology Authors: Adam R. Wolfe, Wendy A. Woodward Source Type: research
Biomarkers for Predicting Radiation Response
Radiation therapy is planned according to an individual patient׳s anatomy. Radiation oncologists generally contour the tumor and design the clinical target volume using computed tomography (or magnetic resonance imaging) on a slice-by-slice basis every 1-3mm. Although the radiation field is customized for each individual patient, in most clinical settings the radiation dose selected and the estimated risk of a normal tissue complication is largely based on population averages for the likelihood of tumor control and as well as acute and late toxicity. (Source: Seminars in Radiation Oncology)
Source: Seminars in Radiation Oncology - September 15, 2015 Category: Cancer & Oncology Authors: David G. Kirsch Source Type: research
Recent Technical Advances and Indications for Radiation Therapy in Low-Grade Glioma
The use of radiotherapy in low-grade glioma has been a topic of controversy over the past 2 decades. Although earlier studies showed no overall survival benefit and no dose response, recent studies demonstrate a possible synergism between radiotherapy and chemotherapy. However, many questions remained unanswered regarding the proper management including the potential roles of biological imaging in treatment planning, the role of reirradiation after recurrence, the role of intensity-modulated radiation therapy and proton beam radiotherapy, and the proper choice of chemotherapy agents. (Source: Seminars in Radiation Oncology)
Source: Seminars in Radiation Oncology - June 5, 2015 Category: Cancer & Oncology Authors: Michael D. Chan Source Type: research
Advances in Magnetic Resonance Imaging and Positron Emission Tomography Imaging for Grading and Molecular Characterization of Glioma
This article highlights advances in magnetic resonance imaging (MRI), including diffusion-weighted imaging, diffusion tensor imaging, magnetic resonance spectroscopy, dynamic contrast-enhanced imaging, and perfusion MRI, as well as position emission tomography using various tracers including methyl-11C-l-methionine and O-(2-18F-fluoroethyl)-l-tyrosine. (Source: Seminars in Radiation Oncology)
Source: Seminars in Radiation Oncology - June 5, 2015 Category: Cancer & Oncology Authors: Caroline Chung, Ur Metser, Cynthia Ménard Source Type: research
Advances in Magnetic Resonance and Positron Emission Tomography Imaging: Assessing Response in the Treatment of Low-Grade Glioma
Following combined-modality therapy for the treatment of low-grade gliomas, the assessment of treatment response and the evaluation of disease progression are uniformly challenging. In this article, we review existing response criteria, and discuss the limitations of conventional magnetic resonance imaging to distinguish between progression and treatment effect. We review the data on advanced imaging techniques including positron emission tomography and functional magnetic resonance imaging, which may enhance the interpretation of posttreatment changes, and enable the earlier assessment of the efficacy and toxicity of ther...
Source: Seminars in Radiation Oncology - June 5, 2015 Category: Cancer & Oncology Authors: Michelle M. Kim, Theodore S. Lawrence, Yue Cao Source Type: research
