Technological Advances in Radiation Oncology for Central Nervous System Tumors

Noda, Shin‐ei; Lautenschlaeger, Tim; Siedow, Michael; Patel, Disha; El‐Jawahri, Areej; Suzuki, Yoshiyuki; Loeffler, Jay S.; Bussière, Marc R.; Chakravarti, Arnab

doi:10.1016/j.semradonc.2009.02.006

Cited by 15 publications

(13 citation statements)

References 69 publications

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“…External beam radiation therapy (EBRT) is used in the treatment of many cancers, but the methods for monitoring changes in the tumor volume during the course of treatment are dependent on image guidance by CT or MRI [1], and the ability to guide therapy based upon molecular signals has been heavily examined yet remains unsuccessful to date. A course of treatment lasts 2 to 10 weeks with daily radiation treatment fractions; ideally image guidance or molecular response would be measured during treatment, maximizing the targeting of radiation and individualizing therapy based upon tumor volumes and molecular signals.…”

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confidence: 99%

Čerenkov excited fluorescence tomography using external beam radiation

Demers¹,

Davis²,

Zhang³

et al. 2013

Opt. Lett.

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Radiation treatment of cancer induces an optical Čerenkov emission throughout the treated volume, which could be used to excite molecular reporters in vivo, allowing molecular sensing of tissue response during fractionated therapy. In this letter, the idea that spatial mapping of this signal can be achieved with tomographic recovery of the fluorophore distribution is tested for the first time, using 6 MeV photons from a linear accelerator in a heterogeneous tissue phantom. Čerenkov light excited fluorophore throughout the tissue phantom, and diffuse tomography was used to recover images. Measurements from13 locations were used, with spectrometer detection and spectral fitting, to separate the fluorophore emission from the Čerenkov continuum. Fluorescent diffuse tomographic images showed a linear response between the concentration and the reconstructed values. The potential to apply this molecular imaging in treatment with molecular reporters appears promising.

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confidence: 99%

Čerenkov excited fluorescence tomography using external beam radiation

Demers¹,

Davis²,

Zhang³

et al. 2013

Opt. Lett.

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“…Similar to other radioresistant tumors, the therapeutic approach for cerebral malignant glioma, which has one of the poorest prognoses among systemic tumors because of its extremely high resistance to various chemotherapeutic and radiotherapeutic approaches, 6 the use of CB therapy had already started an early phase of development. 7 Although intracranial chordoma indicated an excellent outcome after CB treatment (overall survival 89.4% per 3 years) compared with conventional radiotherapy, 8 the results of glioma therapy by CB irradiation were not considered to be better.…”

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confidence: 99%

MEK–ERK-dependent multiple caspase activation by mitochondrial proapoptotic Bcl-2 family proteins is essential for heavy ion irradiation-induced glioma cell death

et al. 2010

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Recently developed heavy ion irradiation therapy using a carbon beam (CB) against systemic malignancy has numerous advantages. However, the clinical results of CB therapy against glioblastoma still have room for improvement. Therefore, we tried to clarify the molecular mechanism of CB-induced glioma cell death. T98G and U251 human glioblastoma cell lines were irradiated by CB, and caspase-dependent apoptosis was induced in both cell lines in a dose-dependent manner. Knockdown of Bax (BCL-2-associated X protein) and Bak (BCL-2-associated killer) and overexpression of Bcl-2 or Bcl-xl (B-cell lymphoma-extra large) showed the involvement of Bcl-2 family proteins upstream of caspase activation, including caspase-8, in CB-induced glioma cell death. We also detected the activation of extracellular signal-regulated kinase (ERK) and the knockdown of ERK regulator mitogen-activated protein kinase kinase (MEK)1/2 or overexpression of a dominant-negative (DN) ERK inhibited CB-induced glioma cell death upstream of the mitochondria. In addition, application of MEK-specific inhibitors for defined periods showed that the recovery of activation of ERK between 2 and 36 h after irradiation is essential for CB-induced glioma cell death. Furthermore, MEK inhibitors or overexpression of a DN ERK failed to significantly inhibit X-ray-induced T98G and U251 cell death. These results suggested that the MEK–ERK cascade has a crucial role in CB-induced glioma cell death, which is known to have a limited contribution to X-ray-induced glioma cell death.

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“…Two-dimensional techniques evolved to three-dimensional techniques with implementation of CT planning scans. The development of inverse planning such as intensity-modulated radiotherapy (IMRT) and volumetric-modulated arc therapy (VMAT) have allowed for even more precise RT delivery while sparing normal tissues and decreasing associated toxicity (13). High precision with patient immobilization, imaging guidance, and steep dose gradient allows for high-dose treatment delivery, which is most suitable for melanoma.…”

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confidence: 99%

Radiation Therapy for Melanoma

Shi

2017

Cutaneous Melanoma: Etiology and Therapy

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Although melanoma is a relative radioresistant tumor, radiation therapy (RT) remains a valid and effective treatment option for the management of melanoma. RT as a primary treatment is often offered in well-defined situations, such as medical inoperability, lentiginous melanoma, mucosal melanoma, and ocular melanoma. Adjuvant RT following lymphadenectomy in node-positive melanoma patients prevents local and regional recurrence; however, the role of adjuvant RT remains controversial and underutilized due to lack of overall survival benefit. On the other hand, RT is highly effective in providing symptom palliation for metastatic melanoma and is widely used. Advanced RT technologies such as stereotactic radiosurgery (SRS) and stereotactic body radiotherapy (SBRT) can achieve excellent local control with minimum toxicities. They are commonly used in the management of brain, lung, spine, and liver metastases. Most recently, it is under active investigation on combining RT with new systemic options, such as targeted therapy, or immunotherapy. The advancements in the treatment of patients with melanoma highlight the importance of multidisciplinary management in this disease. Radiation therapy will continue to be one of the key therapeutic options.

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Technological Advances in Radiation Oncology for Central Nervous System Tumors

Cited by 15 publications

References 69 publications

Čerenkov excited fluorescence tomography using external beam radiation

Čerenkov excited fluorescence tomography using external beam radiation

MEK–ERK-dependent multiple caspase activation by mitochondrial proapoptotic Bcl-2 family proteins is essential for heavy ion irradiation-induced glioma cell death

Radiation Therapy for Melanoma

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