Clinical Radiobiology and Normal-Tissue Morbidity after Breast Cancer Treatment

Bentzen, Søren M.; Overgaard, Marie

doi:10.1016/b978-0-12-035418-4.50006-5

Cited by 26 publications

(12 citation statements)

References 91 publications

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“…3 43 T1N1M0 A C 11 50 6e 4 49 T1N0M0 A 14 50 9e 5 44 T1N0M0 R 18 50 6x 6 47 T1N0M0 R 39 40+16 1 10x/9e 7 69 T1N0M0 R 47 40+16 1 6x/7e 8 48 T2N0M0 A 50 50 9e 9 50 T2N1M0 R C 65 50 6x 10 59 T1N1M0 R H 72 40 6x TNM-staging: A, ablation; C, chemotherapy; e, electron energy; H, hormone; M, metastasis; N, involvement of regional lymph nodes; R, breast resection; T, tumor size; x, photon energy. 1 Booster to the surgical scar.…”

Section: Pinp Immunohistochemistrymentioning

confidence: 99%

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The production of collagen and the activity of mast‐cell chymase increase in human skin after irradiation therapy

Riekki

Harvima²,

Jukkola

et al. 2004

Experimental Dermatology

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Fibrosis is a common complication of radiotherapy. The pathogenesis of radiation-induced fibrosis is not known in detail. There is increasing evidence to suggest that mast cells contribute to various fibrotic conditions. Several mast-cell mediators have been proposed to have a role in fibrogenesis. Tryptase and chymase, the predominant proteins in mast cells, have been shown to induce fibroblast proliferation and collagen synthesis in vitro. In order to explore the role of mast cells in irradiation-induced fibrosis, we analyzed skin biopsies and suction blister fluid (SBF) samples from the lesional and healthy-looking skin of 10 patients who had been treated for breast cancer with surgery and radiotherapy. The biopsies were analyzed histochemically for mast-cell tryptase, chymase, kit receptor, and tumor necrosis factor-alpha. Skin collagen synthesis was assessed by determining the levels of type I and III procollagen amino-terminal propeptides (PINP and PIIINP) in SBF and using immunohistochemical staining for PINP. Immunohistochemical stainings for prolyl-4-hydroxylase reflecting collagen synthesis and chymase immunoreactivity in irradiated and control skin were also performed. The mean level of procollagen propeptides in SBF, which reflects actual skin collagen synthesis in vivo, was markedly increased in irradiated skin compared to corresponding healthy control skin areas. The mean number of PINP-positive fibroblasts was also significantly increased in the upper dermis of radiotherapy-treated skin. The number of cells positive for tryptase, chymase and kit receptor was markedly increased in irradiated skin. In addition, using double-staining techniques, it was possible to demonstrate that in some areas of the dermis, tryptase-positive mast cells and fibroblasts are closely associated. These findings suggest a possible role of mast cells in enhanced skin collagen synthesis and fibrosis induced by radiotherapy.

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Section: Pinp Immunohistochemistrymentioning

confidence: 99%

“…High-dose irradiation may, however, also damage normal tissue. One of the most problematic side effects of radiotherapy is fibrosis of skin and other organs (1). Changes in collagen metabolism evidently have an important role in the pathogenesis of fibrosis (2).…”

Section: Introductionmentioning

confidence: 99%

The production of collagen and the activity of mast‐cell chymase increase in human skin after irradiation therapy

Riekki

Harvima²,

Jukkola

et al. 2004

Experimental Dermatology

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“…4 It generally inhibits the growth of epithelial cells, but induces chemotaxis of fibroblasts. The induction of transforming growth factor ␤ (TGF-␤) is one of the documented nonhormonal effects of TAM.…”

Section: Lesley Seymour On Behalf Of the Br20 Study Teammentioning

confidence: 99%

The Debate About Maintenance Is Not Over in Small-Cell Lung Cancer

Artaç

Bozcuk

2007

JCO

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TO THE EDITOR:We read with interest the study of Arnold et al 1 about vandetanib as a maintenance therapy in patients with small-cell lung cancer (SCLC). They reported that maintenance therapy in SCLC with both chemotherapy and other agents did not affect the survival. However, a meta-analysis revealed the improvement of survival in SCLC with maintenance chemotherapy. 2 In this metaanalysis, maintenance chemotherapy improved 1-and 2-year overall survival by 9% (from 30% to 39%) and 4% (from 10% to 14%), respectively. Similarly, 1-and 2-year progression-free survival were also improved. Indeed, only a few randomized clinical trials reported so far (three of 14) have shown an overall survival difference in favor of maintenance chemotherapy. It is interesting that in two trials showing the superiority of maintenance chemotherapy, the induction therapy was cyclophosphamide, adriamycin, and vincristine, and the maintenance regimen was etoposide and cisplatin. 3,4 These two trials perhaps show that the inclusion of a less cross-resistant second-line chemotherapeutic regimen might improve the therapeutic efficacy of the whole strategy.Another issue about the study by Arnold et al 1 is that although this was a randomized trial, the patients receiving vandetanib were less likely to have received chemotherapy (28% v 32%) and radiation (34% v 43%) after progression. Could this have affected overall survival? In our opinion, this should be regarded as a confounding factor that could have diminished the survival in the vandetanib arm.In short, we believe the debate about the role of maintenance approaches in the management of SCLC is not over. Biologic agents and/or novel chemotherapeutic regimens should be tested in randomized trials in the maintenance setting.

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“…It occurs in up to two-thirds of women whose treatment includes extensive surgical clearance of nodes in the axilla followed by axillary radiotherapy 17. In those treated with axillary irradiation but without axillary surgery, lymphodema occurs in about 8% 17…”

Section: Specific Reactionsmentioning

confidence: 99%

Late complications of radiotherapy

1997

DTB

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Radiotherapy is a standard part of cancer management. Irradiation often causes acute unwanted reactions, such as nausea, diarrhoea or redness of the skin, which, although troublesome, normally resolve within a few weeks.1 Acute bone marrow depression can also occur, particularly following irradiation of the whole body, but this too may be transient.2 In some patients, unwanted reactions develop months or years after treatment is completed. Here we review these late complications and consider how they can be prevented or managed.

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Clinical Radiobiology and Normal-Tissue Morbidity after Breast Cancer Treatment

Cited by 26 publications

References 91 publications

The production of collagen and the activity of mast‐cell chymase increase in human skin after irradiation therapy

The production of collagen and the activity of mast‐cell chymase increase in human skin after irradiation therapy

The Debate About Maintenance Is Not Over in Small-Cell Lung Cancer

Late complications of radiotherapy

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