Showing papers in "Clinical Oncology in 2015"

TL;DR: Joint efforts should be made to establish at least one radiotherapy facility in countries where they do not exist, in order to create radiotherapy communities that could be the base for future expansion.

TL;DR: Technical approaches to minimising heart dose in breast cancer radiotherapy include optimisation of beam angles, use of multileaf collimator shielding, intensity-modulated radiotherapy, treatment in a prone position, and treatment in deep inspiration (including the use of breath-hold and gating techniques).

TL;DR: This manuscript describes the use of evidence-based treatment guidelines to determine indications for radiotherapy and uses epidemiological data to estimate the proportion of the population who have attributes that suggest a benefit from radiotherapy in order to calculate the overall proportion of a population of new cases of cancer who appropriately could be recommended to undergo radiotherapy.

TL;DR: It is shown how highly conformal dose delivery combined with quasi-parallel normal tissue behaviour (n close to 1) enables 'safe' hypofractionation; this can be predicted by the (α/β)eff concept for normal tissues.

TL;DR: All 32 published hypoxia signatures are summarized, their commonalities and differences are discussed, and the importance of reproducibility and gene annotation is highlighted to transfer signatures robustly for clinical application as biomarkers is highlighted.

TL;DR: The intent of breast screening programmes was to detect early invasive cancer, not to identify DCIS, but screen-detected DCIS now accounts for 20% of ‘cancers’ identified through breast screening.

TL;DR: Local ablative treatment seemed to improve the overall survival of the patients who presented with oligometastatic sarcoma, including soft tissue and bone sarcomas, and the survival benefit remained after repeated local treatments for several oligometASTatic events.

TL;DR: Stereotactic body radiotherapy (SBRT) can deliver high radiation doses to small volumes with very tight margins, which has significant advantages when treating tumours close to the spinal cord or at sites of retreatment.

TL;DR: The need to take seriously complaints of pelvic pain from patients after pelvic radiotherapy and to investigate and manage these symptoms more effectively is concluded.

TL;DR: The reported toxicity associated with liver stereotactic body radiotherapy is presented, together with possible pitfalls in interpreting the response to treatment using standard imaging modalities, and potential avenues for future research are highlighted.

TL;DR: A concise description of hypofractionation, the mathematical description of converting between conventional and Hypofractionated radiotherapy treatment schedules, and the motivation for using hyp ofractionation in the treatment of breast and prostate cancer are presented.

TL;DR: Although some radiotherapy predictive biomarkers show promise, there is not enough evidence to justify their use in routine practice and further validation is needed before biomarkers can fulfil their potential and predict treatment outcomes for large numbers of patients.

TL;DR: SBRT has the potential to reduce costs and improve patient quality of life, but in a treatment landscape with many competing options of broadly similar efficacy, randomised trials are essential to define the relative benefits of this approach.

TL;DR: There are nationally agreed algorithms for the investigation and management of PRD, but a lack of awareness means patients still do not get referred appropriately, and the need for high-quality clinical trials is provided.

TL;DR: It is feasible to deliver a high dose of radiation (∼90% of the prescription dose) to the epidural component with volumetric modulated arc therapy SBRT and image guidance and yielded high rates of pain control and local control in patients with spine metastases with or without MEC.

TL;DR: It is suggested that brachytherapy should be considered as a suitable treatment option for treating pelvic malignancy in patients with inflammatory bowel disease, whereas EBRT should be used with caution.

TL;DR: Genetic testing and individualised dose prescriptions could reduce toxicity in radiosensitive patients, and permit isotoxic dose escalation to increase local control in radioresistant individuals.

TL;DR: Elderly patients with glioblastoma selected for treatment (surgery followed by radiation alone or radiation and chemotherapy) survive longer than patients managed with comfort measures, and Prospective randomised trials will help guide management for patients eligible for therapy.

TL;DR: Compared with historical control rates of stage I lung cancers treated with conventionally fractionated radiotherapy, SABR seems to offer higher rates of local control, lower levels of acute toxicity and a better quality of life after treatment.

TL;DR: This study has shown excellent local control rates and acceptable toxicity from the treatment of stage IE low-grade ocular adnexal lymphoma with localised radiotherapy to a median dose of 30 Gy in 15 fractions over 3 weeks.

TL;DR: Although more needs to be done to increase access to radiotherapy in Europe, the situation has improved considerably since the comparable RadioTherapy for Cancer: QUAnification of Infrastructure and Staffing Needs (QUARTS) study reported in 2005.

TL;DR: The process of 1p19q co-deletion assessment using FISH in gliomas from a clinician's perspective is reviewed and common alternative methods of analysis are considered.

TL;DR: Radiotherapy was associated with transient and generally mild impairments in a few aspects of HRQOL, and concerns about adverse effects onHRQOL should not weigh heavily on decisions about adjuvant breast radiotherapy.

TL;DR: Reducing treatment volumes from IFRT to ISRT, INRT or residual volume reduces radiation exposure to OARs, supporting the use of ISRT in the absence of a pre-chemotherapy positron emission tomography scan and suggesting that this reduction in treatment volumes will lead to a reduction in absolute excess second malignancy.

TL;DR: In this paper, the authors compared outcomes of single-fraction and multi-figures stereotactic ablative body radiotherapy (SABR) for pulmonary metastases, and proposed a guideline for R50% conformity incorporating 3D-CRT/IMRT/VMAT with heterogeneity corrected planning algorithms.

TL;DR: IMRT with simultaneous integrated boost is safe and well tolerated in an unselected population and Excellent locoregional control and survival outcomes are achievable outside of a clinical trial setting.

TL;DR: Observed toxicity is minimal with excellent local control rates and this promising treatment paradigm requires further investigation in the context of a randomised controlled trial to establish if the addition of SBRT to standard care improves survival outcomes.

TL;DR: This overview addresses the sexual impact of radical pelvic radiotherapy for the more common adult malignancies and offers an integrated biopsychosocial model of practice that incorporates the physical, psychological and relationship elements of these treatment sequelae.

TL;DR: There is a paucity of evidence available showing a clinical benefit of SBRT, but several international studies are being set-up or have started recruitment, and potential novel therapy combinations with S BRT are discussed.