Bone marrow-sparing intensity-modulated radiation therapy for Stage I seminoma

Abstract

BMS-IMRT reduces markedly the dose to the OARs compared to CT-tRT. This should translate into a reduction in acute and long-term toxicity, as well as into the risk of secondary solid and hematological cancers.

Radiotherapy for Stage IIA seminoma: The Northern Israel Oncology Center Experience, 1971–2010

“…3,5 Among the current radiotherapy strategies to improve the therapeutic ratio in early stage seminoma are computed tomography-based traditional radiotherapy, bone-marrowsparing intensity modulated radiotherapy (BMS-IMRT), reducing the dose to the small and large bowel, stomach, pancreas and liver, and proton therapy. [13][14][15] Proton therapy was able to reduce acute and late treatment morbidity and improve therapeutic ratio through the "spread-out Bragg peak" phenomenon. 14 Proton treatment reduced the mean dose to abdominal and pelvic organs compared to 3-dimensional conformal radiotherapy (3-DCRT) and IMRT with a resultant more favorable dose distribution with less risk to out-of-field radiation-induced malignancies.…”

“…19 If combined modality is given, the relative risk is even higher. 2,9 Pathologically, the pattern of increasing risk of radiation-induced SPC suggests a direct radiogenic effect, and Zilli et al 13 suggested contributing factors, such as scatter dose, number of monitor units, and volume of normal tissues receiving low-dose radiation.…”

Target Volume Delineation for Conformal and Intensity-Modulated Radiation Therapy

“…• IMRT offers a dosimetric disadvantage in terms of mean and D50 % to the liver, bowel, and kidneys compared to 3DRT (Zilli et al 2011 ); proton therapy may offer signifi cant sparing of normal tissues (Efstathiou et al 2012 ); this is under investigation in early phase clinical trials. • For AP-PA beams, one can consider equally weighted fi elds; however, to improve target coverage, unequal weighting may be necessary.…”

Studies of Mucosal Immune Regulation in Celiac Disease and Type 1 Diabetes

“…The disease-inducing properties of rye and barley are suggested to be due to Tcell cross-reactivity against gliadin-, hordein-and secalin-derived peptides [203]. Pure oats, containing avenin, is nowadays considered to be tolerated by most CD patients, and is therefore allowed in the diet in some countries including Sweden [204][205][206][207][208][209][210]. However, a subset of celiac patients being on a GFD containing oats did not normalize their intestinal immune responses [211].…”