Modern Radiotherapy: From Palliation to Cure

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Oncology".

Deadline for manuscript submissions: closed (31 August 2023) | Viewed by 4953

Special Issue Editor


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Guest Editor
Department of Radiation Oncology, Korea University Medical College, Seoul, Republic of Korea
Interests: radiation oncology; stereotactic body radiotherapy; lung cancer; hepatocellular carcinoma; cancer prevention
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Special Issue Information

Dear Colleagues,

Until the 2000s, radiation therapy was mainly used for symptom relief or adjuvant purposes before and after surgery. Of course, symptom relief or minimizing recurrence via multidisciplinary approach are important goals of radiation therapy. With the help of new developments around radiotherapy technology, it has become feasible to irradiate tumors with ablative high doses without overwhelming serious toxicities. The latest stereotactic radiotherapy techniques are used for curative purposes in various cancers, such as liver cancer, lung cancer, and prostate cancer. Furthermore, stereotactic radiotherapy is an effective and non-invasive local modality that can improve the oncological prognosis for oligometastatic disease, which involves ≤3 or 5 metastatic lesions. The introduction of precise radiosurgery techniques or particle therapy has enabled effective therapeutic intervention for recurrent cancer as well. In this Special Issue, we will discuss the role of radiation therapy as a palliative modality or multidisciplinary component, as well as a novel curative option or salvage modality for oligometastasis or recurrent cancer.

Dr. Chai Hong Rim
Guest Editor

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Keywords

  • stereotactic body radiotherapy
  • stereotactic radiosurgery
  • oligometastasis
  • cancer
  • recurrent cancer
  • proton therapy
  • particle therapy

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Published Papers (2 papers)

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Research

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11 pages, 1171 KiB  
Article
Re-Irradiation with Intensity-Modulated Radiation Therapy for the Treatment of Recurrent Cervical Cancer in the Pelvis: An Analysis of Outcomes and Toxicity
by Hye Jin Kang, Yoo-Kang Kwak, So Jung Lee and Myungsoo Kim
Medicina 2023, 59(6), 1164; https://doi.org/10.3390/medicina59061164 - 17 Jun 2023
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Abstract
Background and Objectives: Treatment options for most patients with recurrent cervical cancer within the previously irradiated field are limited. This study aimed to investigate the feasibility and safety of re-irradiation using intensity-modulated radiation therapy (IMRT) for patients with cervical cancer who experienced [...] Read more.
Background and Objectives: Treatment options for most patients with recurrent cervical cancer within the previously irradiated field are limited. This study aimed to investigate the feasibility and safety of re-irradiation using intensity-modulated radiation therapy (IMRT) for patients with cervical cancer who experienced intrapelvic recurrence. Materials and Methods: We retrospectively analyzed 22 patients with recurrent cervical cancer who were treated with re-irradiation for intrapelvic recurrence using IMRT between July 2006 and July 2020. The irradiation dose and volume were determined based on the range considered safe for the tumor size, location, and previous irradiation dose. Results: The median follow-up period was 15 months (range: 3–120) and the overall response rate was 63.6%. Of the symptomatic patients, 90% experienced symptom relief after treatment. The 1- and 2-year local progression-free survival (LPFS) rates were 36.8% and 30.7%, respectively, whereas the 1- and 2-year overall survival (OS) rates were 68.2% and 25.0%, respectively. Multivariate analysis revealed that the interval between irradiations and gross tumor volume (GTV) were significant prognostic factors for LPFS. The response to re-irradiation showed borderline statistical significance for LPFS. The GTV and response to re-irradiation were also independent prognostic factors for OS. Grade 3 late toxicities were observed in 4 (18.2%) of the 22 patients. Recto- or vesico-vaginal fistula occurred in four patients. The irradiation dose was associated with fistula formation with borderline significance. Conclusions: Re-irradiation using IMRT is a safe and effective treatment strategy for patients with recurrent cervical cancer who previously received RT. Interval between irradiations, tumor size, response to re-irradiation, and radiation dose were the main factors affecting efficacy and safety. Full article
(This article belongs to the Special Issue Modern Radiotherapy: From Palliation to Cure)
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12 pages, 1524 KiB  
Review
Oligometastasis: Expansion of Curative Treatments in the Field of Oncology
by Ah Reum Lim and Chai Hong Rim
Medicina 2023, 59(11), 1934; https://doi.org/10.3390/medicina59111934 - 1 Nov 2023
Cited by 1 | Viewed by 1637
Abstract
Oligometastasis is defined as the presence of several limited metastatic lesions and is generally limited to three or fewer than five metastatic lesions. Previously, the treatment of metastatic cancer aimed to alleviate symptoms rather than cure them; however, the use of immunotherapy or [...] Read more.
Oligometastasis is defined as the presence of several limited metastatic lesions and is generally limited to three or fewer than five metastatic lesions. Previously, the treatment of metastatic cancer aimed to alleviate symptoms rather than cure them; however, the use of immunotherapy or targeted therapy has greatly improved patient life expectancy. Additionally, the effectiveness and safety of local treatment have recently been proven for oligometastatic cancers and have significantly improved patient survival and decreased recurrence rates. A few metastatic studies on lung cancer have demonstrated the usefulness of combining radiation therapy and immunotherapy. Recently, local and targeted therapy combinations have shown promising results in treating non-small cell lung cancer, predominantly caused by the epidermal growth factor receptor and anaplastic lymphoma kinase gene mutations, suggesting the potential of these new treatment strategies. It is well known that oligometastasis has better clinical results than polymetastasis; however, research on the biological profile of oligometastasis is still lacking. Studies using circulating tumor DNA and circulating tumor cells are at the initial stages of providing a better understanding of oligometastatic cancers, and the biological characteristics of these cancers may be revealed based on more diverse studies. With the development of these treatments, the prognosis for patients with oligometastatic cancers is steadily improving, and if the biological profile is revealed, customized treatment may be provided. Full article
(This article belongs to the Special Issue Modern Radiotherapy: From Palliation to Cure)
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