Radiotherapy For Cancer Research Articles

Research progress of cardiotoxicity caused by radiotherapy in breast cancer

Research progress of cardiotoxicity caused by radiotherapy in breast cancer

A Machine Learning Approach for Predicting Biochemical Outcome After PSMA-PET–Guided Salvage Radiotherapy in Recurrent Prostate Cancer After Radical Prostatectomy: Retrospective Study

A Machine Learning Approach for Predicting Biochemical Outcome After PSMA-PET–Guided Salvage Radiotherapy in Recurrent Prostate Cancer After Radical Prostatectomy: Retrospective Study

Oligometastatic Urothelial Cancer and Stereotactic Body Radiotherapy: A Systematic Review and an Updated Insight of Current Evidence and Future Directions

Oligometastatic Urothelial Cancer and Stereotactic Body Radiotherapy: A Systematic Review and an Updated Insight of Current Evidence and Future Directions

"Navigating the risks of pediatric head trauma: the role of imaging and radiation safety".

Head trauma is a frequent cause of emergency department visits in children due to their larger head-to-body ratio and developing motor skills. Younger children, especially those under 2years, are at increased risk for skull fractures due to thinner cranial bones. Accurate diagnosis of pediatric skull fractures often requires imaging, including CT scans, which raise concerns about radiation exposure and its associated long-term risks, such as radiation-induced cancers. A recent study by Ono et al. highlights the necessity of follow-up imaging in children under 24months with isolated skull fractures (ISF) initially detected by CT. The study found that follow-up MRI scans revealed new intracranial findings in 40.6% of cases, with some requiring neurosurgical intervention. This underscores the importance of follow-up imaging in pediatric head trauma management. However, repeated imaging, particularly CT scans, increases radiation exposure, necessitating strategies to minimize it. Novel approaches like artificial intelligence (AI) are showing promise in reducing radiation doses by enhancing scan planning, patient positioning, and improving the quality of low-dose images. Despite the study's significant findings, limitations such as its retrospective design, potential selection bias, and single-institution setting restrict generalizability. Future research should adopt prospective designs, include broader case ranges, and involve multiple centers to validate findings. In conclusion, while timely imaging is crucial for managing pediatric head trauma, balancing diagnostic accuracy with reducing radiation exposure is essential. Advances in AI present promising avenues for enhancing safety in pediatric imaging.

PEARL: A Phase Ib/II Biomarker Study of Adding Radiation Therapy to Pembrolizumab Before Neoadjuvant Chemotherapy in Human Epidermal Growth Factor Receptor 2–Negative Breast Cancer

PURPOSE To assess safety and immune biomarkers after preoperative radiation therapy (RT) and anti-PD1 therapy in breast cancer. MATERIALS AND METHODS A phase I/IIb trial of pembrolizumab with RT was conducted in patients with triple-negative breast cancer (TNBC) and hormone receptor–positive/human epidermal growth factor receptor 2–negative (HR+/HER2–) breast cancer. All received pembrolizumab followed by a second cycle + RT (anti-PD1/RT) of 24 Gy/three daily fractions delivered to the breast tumor and then neoadjuvant chemotherapy (NAC). Blood and tumor biopsies were obtained at baseline, after anti-PD1, and after anti–PD-RT. Coprimary end points were safety and change in tumor-infiltrating lymphocytes (TILs). Secondary end points were pathologic complete response (pCR), residual cancer burden (RCB) rates, and event-free survival (EFS). RESULTS Sixty-six patients with stage I-III breast cancer (54 TNBC, 12 HR+/HER2–) were enrolled. The median follow-up was 32 months. Safety end point was met. Incidence of grade ≥3 toxicities was 41%. The pCR rate was 59.2%, 33.3%, and 54.5% for the TNBC, HR+/HER2–, and entire cohort, respectively. A total of 77.8% of TNBC and 41.6% of HR+/HER2– had a near pCR (RCB 0-1). The 3-year EFS was 80%. In the entire cohort, PD-L1 expression increased after anti-PD1 (median Combined Positive Score [CPS], 7.49-23.20; 95% CI, –41.88 to –6.30; P = .044) and anti-PD1/RT (median CPS, 7.49-23.41; 95% CI, –41.88 to –6.30; P = .009), compared with baseline. In TNBC, adding RT to anti-PD1 significantly decreased TILs (28.9%-17.1%; 95% CI, 2.46 to 21.09; P = .014). Baseline TILs correlated with PD-L1 expression and TNF-a. CONCLUSION Preoperative RT with pembrolizumab is safe and results in high pCR rates and 3-year EFS, despite the lack of pembrolizumab during NAC. PD-L1 and TILs may be predictive biomarkers for preoperative anti-PD1/RT response. Reduction in TILs after adding RT to anti-PD1 highlights the importance of treatment sequencing.

An in vitro assessment of ionizing radiation impact on the efficacy of radiotherapy for breast cancer

Abstract Objectives Ionizing radiation is still one of the most effective treatment options for various cancers. It is possible to reduce the side effects of this effective treatment method and increase the chance of success by elucidating the responses it creates at the molecular level in the cell. This study aims to investigate of the molecular effects of therapeutic ionizing radiation on breast cancer, which is the most prevalent cancer type. Methods MDA-MB-231 and MCF7 cell lines were irradiated with 4 and 8 Gy ionizing radiation and monitored for up to 7 days. RNA was collected at 48 and 96 h, when cellular molecular mechanisms became most evident, and quantitative expression levels of microRNAs (miR-208a, miR-124, miR-145), for which cancer-radiation associations have been determined from existing literature and databases, were evaluated. Results Exposure to ionizing radiation resulted in a dose-dependent reduction in cell viability in both MCF7 and MDA-MB-231 breast cancer cell lines. Furthermore, microRNA expression analysis revealed notable changes at all levels. The research demonstrates that miR-208a, miR-145, and miR-124 are crucial in the biological response to ionizing radiation. Conclusions Therapeutic ionizing radiation profoundly affects cell viability and microRNA expression in breast cancer cell lines, showing dose and time-dependent effects. The observed microRNA expression patterns suggest potential biomarkers for radiation response and therapeutic targets to improve radiotherapy efficacy. Further in vivo validation and exploration of these microRNAs’ roles in modulating cellular response to ionizing radiation are needed.

A Thorough Review on Ethnomedicinal Value of Bioactive Compounds of Pteridophytes against Cancer: Clinical Applications and Future Prospects

Most cancers have become immune to normal cancer therapy, like chemotherapy and radiation. Therefore, exploring more effective and economical treatment options is important. Plants and herbs contain substances called phytochemicals, which have biological effects. Many phytochemicals having antioxidant and anticancer properties have been studied previously. There is increasing evidence that phytochemicals' anti-carcinogenic benefits originate from their ability to inhibit oxidation, inflammation, cell proliferation, and angiogenesis. These phytochemicals inhibit the spread of cancer by controlling the cell cycle and other molecular processes, such as metastasis. Along with therapeutic potential, other advantages, like their abundance, greater tolerability, and economic use, increase their utility in cancer therapeutics. In recent years, a number of scientists have examined lycophytes and ferns for their potential medicinal and phytochemical properties. This analysis emphasizes the significance of chemicals obtained from ferns and their derivatives in therapeutics. The authors discuss the pteridophyte's anti-cancer properties and other medical uses in this article. This information may help researchers in further research related to the most promising anticancer phytochemicals and their possibility as alternative drugs against cancer.

Development of Melanoma and Other Nonkeratinocyte Skin Cancers After Thyroid Cancer Radiation

This cohort study evaluates the association between thyroid malignant neoplasms and melanoma and other nonkeratinocyte skin cancers.

Enhancement of gold-curcumin nanoparticle mediated radiation response for improved therapy in cervical cancer: a computational approach and predictive pathway analysis.

Radiotherapy is prevalently applied for highly effective cancer therapy while the low specificity of radiation is deleterious to the nearby healthy cells. High-Z-based nanomaterials offer excellent radio-enhancement properties while natural products provide radioprotection. Modulation of the radiotherapeutic index via applying nanomaterials is feasible for effective treatment however, the scenario changes when simultaneous protection of non-cancerous cells is required. Here, we report the modulatory radiotherapeutic effect of curcumin conjugated gold nanoparticles in a single nanoformulation to pave the long-awaited hope of a single combination-based, cell-selective radio enhancer, and protectant for cancer radiotherapy. We have validated the effective radiation dose along with the combination of the radio-nano-modulator by a reverse experimentation statistical model. The concept was supported by different sets of experiments, like quantification of ROS generation, cell cycle monitoring, mitochondrial membrane potential measurement, etc. along with gene expression study, and predictive modeling of molecular pathways of the killing mechanism. In conclusion, the nanoconjugate showed a promise to become a candidate for the pH-dependent cell-specific radio-modulator.

Machine learning automated treatment planning for online magnetic resonance guided adaptive radiotherapy of prostate cancer

Background and purposeNo best practices currently exist for achieving high quality radiation therapy (RT) treatment plan adaptation during magnetic resonance (MR) guided RT of prostate cancer. This study validates the use of machine learning (ML) automated RT treatment plan adaptation and benchmarks it against current clinical RT plan adaptation methods. Materials and methodsWe trained an atlas-based ML automated treatment planning model using reference MR RT treatment plans (42.7 Gy in 7 fractions) from 46 patients with prostate cancer previously treated at our institution. For a held-out test set of 38 patients, retrospectively generated ML RT plans were compared to clinical human-generated adaptive RT plans for all 266 fractions. Differences in dose-volume metrics and clinical objective pass rates were evaluated using Wilcoxon tests (p < 0.05) and Exact McNemar tests (p < 0.05), respectively. ResultsCompared to clinical RT plans, ML RT plans significantly increased sparing and objective pass rates of the rectum, bladder, and left femur. The mean ± standard deviation of rectum D20 and D50 in ML RT plans were 2.5 ± 2.2 Gy and 1.6 ± 1.3 Gy lower than clinical RT plans, respectively, with 14 % higher pass rates; bladder D40 was 4.6 ± 2.9 Gy lower with a 20 % higher pass rate; and the left femur D5 was 0.8 ± 1.8 Gy lower with a 7 % higher pass rate. ConclusionsML automated RT treatment plan adaptation increases robustness to interfractional anatomical changes compared to current clinical adaptive RT practices by increasing compliance to treatment objectives.

Ejaculatory function after radiotherapy for prostate cancer: a systematic review and meta-analysis.

Scant data exists on the impacts of prostate radiation on ejaculatory function. We performed a systematic review and meta-analysis to assess ejaculatory outcomes in men after prostate radiation. We queried PubMed, Embase, and Web of Science to identify 17 articles assessing ejaculatory function post-radiation. The primary outcome was anejaculation rate and secondary outcomes included ejaculatory volume (EV), ejaculatory discomfort, and mean decline in ejaculatory function scores (EFS). We assessed study quality with the Newcastle-Ottawa scale. We calculated pooled proportions using inverse variance and random effects models. We identified 17 observational studies with 2156 patients reporting ejaculatory profiles post-radiation. Seven studies utilized external beam radiation therapy, 7 brachytherapy, 1 stereotactic RT and 2 utilized either external or brachytherapy. Ten studies reported an anejaculation rate. Pooled proportion of patients having anejaculation, decreased EV and EjD were 18% (95% CI, 11-36%), 85% (95% CI, 81-89%) and 24% (95% CI, 16-35%), respectively. Five studies reported decline in EFS post-radiation. Patients receiving radiation treatment may experience significant changes in their ejaculation, such as the absence of ejaculation, reduced EV, and EjD. It is important to counsel them about these potential side effects.

Is intensive training with atime interval between instruction and planning CT necessary for deep inspiration breath-hold radiotherapy in breast cancer?

Breathing instruction and exercises and atime gap between training and planning CT scans (pCT) is recommended as part of deep inspiration breath-hold (DIBH) assisted radiotherapy (RT). However, this is associated with additional time expenditure. In two of the authors' treatment centers (TC), patient training took place before the planning CT of DIBH-assisted therapy. In TC1, afurther appointment was made with aminimum interval of 2days to perform the planning CT. At TC2, the planning CT was performed immediately after the first patient instruction. Aretrospective evaluation of the clinical parameters of the therapy was carried out to investigate the relevance of the time gap between DIBH exercises and pCT. Atotal of 72patients were included, 35 of whom were treated in TC1 and37 in TC2. In TC1, an average interval of ~4 days was observed between patient training and planning CT, while in TC2, training and CT were performed immediately after each other. No significant differences in radiation dose exposure of the lung on the treated side, the whole lung, or the heart were found between the two centers. Furthermore, there was no significant difference in the application of the daily RT fraction. The requirement for daily positioning checks was also the same at both treatment centers. This study does not show any advantages for atime gap between instruction/training and pCT. Skipping the time break does not deteriorate any clinically relevant endpoints.

Spatially fractionated GRID radiation potentiates immune-mediated tumor control

BackgroundTumor-immune interactions shape a developing tumor and its tumor immune microenvironment (TIME) resulting in either well-infiltrated, immunologically inflamed tumor beds, or immune deserts with low levels of infiltration. The pre-treatment immune make-up of the TIME is associated with treatment outcome; immunologically inflamed tumors generally exhibit better responses to radio- and immunotherapy than non-inflamed tumors. However, radiotherapy is known to induce opposing immunological consequences, resulting in both immunostimulatory and inhibitory responses. In fact, it is thought that the radiation-induced tumoricidal immune response is curtailed by subsequent applications of radiation. It is thus conceivable that spatially fractionated radiotherapy (SFRT), administered through GRID blocks (SFRT-GRID) or lattice radiotherapy to create areas of low or high dose exposure, may create protective reservoirs of the tumor immune microenvironment, thereby preserving anti-tumor immune responses that are pivotal for radiation success.MethodsWe have developed an agent-based model (ABM) of tumor-immune interactions to investigate the immunological consequences and clinical outcomes after 2Gy×35\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$2\\,\ ext{Gy} \ imes 35$$\\end{document} whole tumor radiation therapy (WTRT) and SFRT-GRID. The ABM is conceptually calibrated such that untreated tumors escape immune surveillance and grow to clinical detection. Individual ABM simulations are initialized from four distinct multiplex immunohistochemistry (mIHC) slides, and immune related parameter rates are generated using Latin Hypercube Sampling.ResultsIn silico simulations suggest that radiation-induced cancer cell death alone is insufficient to clear a tumor with WTRT. However, explicit consideration of radiation-induced anti-tumor immunity synergizes with radiation cytotoxicity to eradicate tumors. Similarly, SFRT-GRID is successful with radiation-induced anti-tumor immunity, and, for some pre-treatment TIME compositions and modeling parameters, SFRT-GRID might be superior to WTRT in providing tumor control.ConclusionThis study demonstrates the pivotal role of the radiation-induced anti-tumor immunity. Prolonged fractionated treatment schedules may counteract early immune recruitment, which may be protected by SFRT-facilitated immune reservoirs. Different biological responses and treatment outcomes are observed based on pre-treatment TIME composition and model parameters. A rigorous analysis and model calibration for different tumor types and immune infiltration states is required before any conclusions can be drawn for clinical translation.

Comparison of liposomal gel with and without chamomile to prevent radiation dermatitis in breast cancer patients: arandomized controlled trial.

To compare aliposomal gel with and without chamomile extract for the prevention of radiation dermatitis in breast cancer patients undergoing radiotherapy. This study was adouble-blind randomized clinical trial. Atotal of 100 participants undergoing radiotherapy for breast cancer were recruited. The primary outcome was the occurrence of dry desquamation. Cumulative dose of ionizing radiation at the first occurrence of dry desquamation, occurrence of erythema, moist desquamation, global radiation dermatitis, and any signs and symptoms self-reported by participants were secondary outcomes. Dry desquamation occurred in 6.0% of the participants using chamomile liposomal gel and 12.2% of those using liposomal gel (p = 0.32). The mean cumulative dose of ionizing radiation for the first occurrence of dry desquamation was 45.1 Gy in the chamomile liposomal gel group and 43.7 Gy in the liposomal gel group. There were no differences between the two gels in the occurrence of erythema, dry desquamation, moist desquamation, and radiation dermatitis compared to liposomal gel. There was alower proportion of reported symptoms in the chamomile liposomal gel group compared to liposomal gel group in the first 3weeks of radiation, especially for itching (p = 0.05). No statistically significant differences between the two gels were found in radiation dermatitis occurrence and dose at first occurrence. Comparing to the literature, it seems that both interventions may be effective, which might explain the lack of statistical difference between the groups.

CT-Based Adaptive Short Course Radiotherapy for Rectal Cancer: A Case Report

CT-Based Adaptive Short Course Radiotherapy for Rectal Cancer: A Case Report

Assessment of Volumetric Changes Using Megavoltage-Cone Beam Computed Tomography (MV-CBCT) for Adaptive Radiotherapy in Head and Neck Cancer: A Case Series

Assessment of Volumetric Changes Using Megavoltage-Cone Beam Computed Tomography (MV-CBCT) for Adaptive Radiotherapy in Head and Neck Cancer: A Case Series

Randomised controlled trials on radiation dose fractionation in breast cancer: systematic review and meta-analysis with emphasis on side effects and cosmesis

ObjectiveTo provide a comprehensive assessment of various fractionation schemes in radiation therapy for breast cancer, with a focus on side effects, cosmesis, quality of life, risks of recurrence, and survival...

Synthesis of trimetallic iron-boron core and gold shell nanoparticles for experimental cancer radiotherapy

Synthesis of trimetallic iron-boron core and gold shell nanoparticles for experimental cancer radiotherapy

Exploring the impact of field shape on predicted dose distribution in breast cancer patients using deep learning in radiation therapy

BackgroundGeometrical information such as field shape is essential for dose calculation in radiation therapy. However, new methods of dose prediction based on deep learning only use CT images and contouring of patients. The aim of this study is to develop a deep learning method for three-dimensional dose prediction for breast cancer radiotherapy using field shape as well as CT and contouring images of patients. MethodsA total of 150 breast cancer patients' data treated with 3D conformal radiation therapy (CRT) technique were used to train and test 3D-U-Res-F-Net model. The model inputs were CT images, patients' contouring and field shape. The network output was the corresponding the patients’ dose distribution. Then, the dosimetric parameters extracted from the dose volume histograms related to the planned and predicted dose distributions were compared and were statistically analysed with the paired-samples t-test. These parameters include Dmean and Dmax for planning target volume and organs at risk, D95%, D50%, V47.5Gy for PTV, V30Gy and V25Gy for heart and V20Gy for left lung. The gamma index with 3%/3 mm criteria was calculated for PTV and OARs. ResultsThe average absolute difference of the Dmean relative to the prescribed dose for the PTV, heart, left lung, right lung and spinal cord were 1.37 ± 0.4%, 2.02 ± 2%, 2.12 ± 1%, 0.37 ± 0.3% and 0.41 ± 0.3%, respectively. The average absolute difference of the Dmax relative to the prescribed dose for the PTV and OARs varied from 0.23 ± 0.2% to 2.04 ± 2%. The 3D gamma pass rate with 3mm/3% criteria for planning target volume, heart, left lung, right lung, spinal cord and body were 89 ± 3%, 91 ± 5%, 93 ± 5%, 99 ± 3%, 99 ± 1% and 96 ± 2% respectively. ConclusionsThe results of the proposed model demonstrate that there is no significant difference between the predicted and planned dose distributions. The deep learning model can directly predict the 3D dose distribution faster than treatment planning systems. Further studies with more patients and on other cancer sites are essential to fully validate the proposed method.

Biology-guided radiotherapy in metastatic prostate cancer: time to push the envelope?

The therapeutic landscape of metastatic prostate cancer has undergone a profound revolution in recent years. In addition to the introduction of novel molecules in the clinics, the field has witnessed a tremendous development of functional imaging modalities adding new biological insights which can ultimately inform tailored treatment strategies, including local therapies. The evolution and rise of Stereotactic Body Radiotherapy (SBRT) have been particularly notable in patients with oligometastatic disease, where it has been demonstrated to be a safe and effective treatment strategy yielding favorable results in terms of disease control and improved oncological outcomes. The possibility of debulking all sites of disease, matched with the ambition of potentially extending this treatment paradigm to polymetastatic patients in the not-too-distant future, makes Biology-guided Radiotherapy (BgRT) an attractive paradigm which can be used in conjunction with systemic therapy in the management of patients with metastatic prostate cancer.