Stereotactic radiation therapy for breast cancer in the elderly

Jardel, P.; Kammerer, Emmanuel; Villeneuve, Hugo; Thariat, Juliette

doi:10.21037/tcr.2019.07.18

Cited by 4 publications

(4 citation statements)

References 57 publications

(64 reference statements)

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“…The fact that the dose per fraction demonstrated no relationship with local control may also suggest the BED is a more holisitic way to consider dose delivery in this setting. This result also supports the hypothesis that the primary disease histology of spinal metastases should impact therapeutic decision-making [25][26][27][28][29]. Patients with certain tumor histologies, including prostate cancer in our series, may have increased benefit from dose escalation.…”

Section: Discussionsupporting

confidence: 86%

Local control of 1–5 fraction radiotherapy regimens for spinal metastases: an analysis of the impacts of biologically effective dose and primary histology

Kowalchuk

Cousins

Spencer

et al. 2021

Rep Pract Oncol Radiother.

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Background This analysis evaluates the impacts of biologically effective dose (BED) and histology on local control (LC) of spinal metastases treated with highly conformal radiotherapy to moderately-escalated doses. Materials and methods Patients were treated at two institutions from 2010–2020. Treatments with less than 5 Gy per fraction or 8 Gy in 1 fraction were excluded. The dataset was divided into three RPA classes predictive of survival (1). The primary endpoint was LC. Results 223 patients with 248 treatments met inclusion criteria. Patients had a median Karnofsky Performance Status (KPS ) of 80, and common histologies included breast (29.4%), non-small cell lung cancer (15.7%), and prostate (13.3%). A median 24 Gy was delivered in 3 fractions (BED: 38.4 Gy) to a median planning target volume (PTV) of 37.3 cc. 2-year LC was 75.7%, and 2-year OS was 42.1%. Increased BED was predictive of improved LC for primary prostate cancer (HR = 0.85, 95% CI: 0.74–0.99). Patients with favorable survival (RPA class 1) had improved LC with BED ≥ 40 Gy (p = 0.05), unlike the intermediate and poor survival groups. No grade 3–5 toxicities were reported. Conclusions Moderately-escalated treatments were efficacious and well-tolerated. BED ≥ 40 Gy may improve LC, particularly for prostate cancer and patients with favorable survival.

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Section: Discussionsupporting

confidence: 86%

Local control of 1–5 fraction radiotherapy regimens for spinal metastases: an analysis of the impacts of biologically effective dose and primary histology

Kowalchuk

Cousins

Spencer

et al. 2021

Rep Pract Oncol Radiother.

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“…This study was performed assuming SBRT, in which a single exposure provides a higher dose than conventional radiotherapy ( Marcrom et al, 2017 ; Jardel et al, 2020 ; Sarudis et al, 2021 ; Ugurluer et al, 2021 ). Since Lei et al (2021) reported that the survival rate of HeLa was less than 50% after a single 10-Gy irradiation, we selected a single high-dose of 10-Gy irradiation.…”

Section: Discussionmentioning

confidence: 99%

“…In radiotherapy, stereotactic radiotherapy involves the delivery of higher doses (7–18 Gy or more) than the usual single-beam dose (1.8–2 Gy) and is used to treat various cancers ( Marcrom et al, 2017 ; Jardel et al, 2020 ; Sarudis et al, 2021 ; Ugurluer et al, 2021 ). Stereotactic radiotherapy was originally used to treat brain cancers, with stereotactic body radiotherapy (SBRT) representing the application of this technology to the trunk of the body, such as for lung and liver cancers ( Song et al, 2004 ; Donovan and Swaminath, 2018 ; Tandberg et al, 2018 ; Sarudis et al, 2021 ; Ugurluer et al, 2021 ).…”

Section: Introductionmentioning

confidence: 99%

A single high-dose irradiation changes accumulation of methotrexate and gene expression levels of SLC and ABC transporters in cancer cells

et al. 2023

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Chemoradiotherapy is frequently used to treat cancer. Stereotactic body radiotherapy (SBRT) is a single high-dose radiotherapy used to treat a variety of cancers. The anticancer drug methotrexate (MTX) shows affinity for solute carrier (SLC) and ATP-binding cassette (ABC) transporters. This study investigated relationships between accumulation of methotrexate and gene expression levels of solute carrier and ATP-binding cassette transporters in cancer cells after a single and high-dose X-ray irradiation. Cancer cell lines were selected from lung and cervical cancer cell line that are commonly used for stereotactic body radiotherapy and effective with methotrexate. We examined expression levels of organic anion-transporting polypeptide (OATP)1B1, OATP1B3, OATP1B7, and organic anion transporter (OAT)1 as solute carrier transporters and multidrug resistance-associated protein (MRP)1 and MRP2 as ATP-binding cassette transporters, using real-time polymerase chain reaction and accumulation of 3H-MTX in cancer cells after 10-Gy irradiation, assuming stereotactic body radiotherapy. Cells were divided into three groups: Control without irradiation; 4 h after irradiation; and 24 h after irradiation. In control, gene expression levels of OAT1 in all cells was below the limit of measurement. After irradiation, gene expression levels of OATP1B1/1B3/1B7 showed changes in each cell line. Gene expression levels of MRP1/2 tended to increase after irradiation. Gene expression levels of OATP1B1/1B3/1B7 were much lower than those of MRP1/2. Accumulation of 3H-MTX tended to decrease over time after irradiation. Irradiation of cancer cells thus alters gene expression levels of both solute carrier transporters (OATP1B1/1B3/1B7) and ABC transporters (MRP1/2) and decreases accumulation of 3H-MTX in cancer cells over time due to elevated expression of MRP1/2.

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“…Two years later, Jardel et al [40] reviewed the literature on SBRT in the elderly patient in the adjuvant, metastatic, and definitive settings. Despite the few studies, SBRT was, however, considered promising for elderly women affected by BC.…”

Section: Discussionmentioning

confidence: 99%

Stereotactic Radiotherapy in Early-Stage Breast Cancer in Neoadjuvant and Exclusive Settings: A Systematic Review

Piras¹,

Sanfratello²,

Boldrini

et al. 2022

Oncol Res Treat

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Introduction Breast cancer (BC) is one of the most common tumours, better screening policies and multidisciplinary approach allow personalised treatment. Radiotherapy (RT) plays a central role in the multimodal approach in BC, and recent evidence have shown the non-inferiority of hypofractionated treatments. The aim of this study is to describe the feasibility and validity of stereotactic RT (SBRT) in BC in neoadjuvant and exclusive setting. Methods A Pubmed/MEDLINE and Embase systematic review was conducted to assess the role of radiomics in BC. The search strategy was “breast [All Fields] AND "stereotactic" [All Fields] AND "radiotherapy" [All Fields])” and only original articles referred to BC in humans in the English language were considered. Results A total of 2149 studies were obtained using the mentioned search strategy on Pubmed and Embase. After the complete selection process, a total of 12 papers were considered eligible for the analysis of the results. SBRT in BC was described in 8 studies regarding neoadjuvant approach and 4 papers regarding exclusive approach. Conclusions Relative low toxicity rates; the reduced treatment volumes in the neoadjuvant setting and the possibility to replace surgery when not feasible in exclusive setting, resulted to be main advantages for SBRT in BC. Current evidence showed as both the neoadjuvant and the definitive settings seem to be promising clinical scenarios for SBRT especially for EBC.

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Stereotactic radiation therapy for breast cancer in the elderly

Cited by 4 publications

References 57 publications

Local control of 1–5 fraction radiotherapy regimens for spinal metastases: an analysis of the impacts of biologically effective dose and primary histology

Local control of 1–5 fraction radiotherapy regimens for spinal metastases: an analysis of the impacts of biologically effective dose and primary histology

A single high-dose irradiation changes accumulation of methotrexate and gene expression levels of SLC and ABC transporters in cancer cells

Stereotactic Radiotherapy in Early-Stage Breast Cancer in Neoadjuvant and Exclusive Settings: A Systematic Review

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