The role of radiotherapy in cancer treatment

Delaney, Geoff P.; Jacob, Susannah; Featherstone, C.; Bartoň, Michael

doi:10.1002/cncr.21324

Cited by 1,333 publications

(554 citation statements)

References 24 publications

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“…The proportion of patients prescribed with radiotherapy in this study is in line with the common benchmark reported in recent years of at least 50% of new cancer patients requiring radiotherapy [20]. Reviewing the available literature, different approaches can be found in Table 2 concerning the estimation of radiotherapy demand in different countries.…”

Section: Discussionsupporting

confidence: 80%

Prescription of Cancer Treatment Modalities in Developing Countries: Results from a Multi-Centre Observational Study

Camacho¹,

Neves²,

Piñeros³

et al. 2014

JCT

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Background: Treatment is an important component of a comprehensive cancer control approach and its outcomes strongly depend on infrastructure, equipment, human and financial resources available. Therefore it is imperative to generate evidence-based tools to assist health policy makers from low resourced countries in planning efficient and equitable treatment services for a defined population based on what it is feasible to these settings. Methods: The intended cancer specific treatment planned and written in the patients' medical record (treatment prescription) of untreated adult cancer cases (≥18 years of age), excluding non-melanoma skin cancer, was recorded in a chronological way from 1 January 2012 onwards in a group of eight comprehensive cancer centres located in middle income countries and offering the main modalities of cancer * Affiliations are as of 1 March 2014. # Corresponding author. R. Camacho et al.990 treatment (surgery, medical oncology and radiotherapy). Results: A total of 17,713 medical records were reviewed, of which 7106 (54.2%) met the eligibility criteria. Prescription of main cancer treatment modalities were distributed as follows: 57.6% for chemotherapy (n = 4093), 56.8% for surgery (n = 4038), and 46.8% for radiotherapy (n = 3327). There was a predominance of plans consisting of combined treatment modalities over monotherapy (55.2% versus 44.8%). At the time of diagnosis 54.3% of the cancer cases had disease that had spread beyond the primary site, 41.2% were considered as having local disease and in 4.5% of the cases the information on disease extension was unknown. Conclusions: The results obtained should be seen as an approximation of cancer treatment service demand based on what it is currently practiced and therefore feasible in developing countries, particularly in middle income countries.

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Section: Discussionsupporting

confidence: 80%

Prescription of Cancer Treatment Modalities in Developing Countries: Results from a Multi-Centre Observational Study

Camacho¹,

Neves²,

Piñeros³

et al. 2014

JCT

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“…1,2 The focus of radiobiology over previous decades has been on the direct cytoreductive effect that RT exerts on cancer cells by inducing DNA damage and only relatively recently have the effects of RT on tumour vasculature, stroma and the immune system received more attention. RT is known to have a number of effects on the generation of tumour-specific immunity, which include enhanced antigen release, expression of Natural killer receptor G2D (NKG2D) ligands, production of Type I Interferon (IFN) and complement, increased major histocompatibility complex and neoantigen expression and the induction of immunogenic cell death (ICD).…”

Section: The Interplay Of Radiotherapy With the Tumour Microenvironmentmentioning

confidence: 99%

Stereotactic ablative radiotherapy and immunotherapy combinations: turning the future into systemic therapy?

Walshaw¹,

Honeychurch²,

Illidge³

2016

BJR

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Radiotherapy (RT) is effective at cytoreducing tumours and until relatively recently the focus in radiobiology has been on the direct effects of RT on the tumour. Increasingly, however, the effect of RT on the tumour vasculature, tumour stroma and immune system are recognized as important to the overall outcome. RT is known to lead to the induction of immunogenic cell death (ICD), which can generate tumour-specific immunity. However, systemic immunity leading to "abscopal effects" resulting in tumour shrinkage outside of the RT treatment field is rare, which is thought to be caused by the immunosuppressive nature of the tumour microenvironment. Recent advances in understanding the nature of this immunosuppression and therapeutics targeting immune checkpoints such as programmed death 1 has led to durable clinical responses in a range of cancer types including malignant melanoma and non-small-cell lung cancer. The effects of RT dose and fraction on the generation of ICD and systemic immunity are largely unknown and are currently under investigation. Stereotactic ablative radiotherapy (SABR) provides an opportunity to deliver single or hypofractionated large doses of RT and potentially increase the amount of ICD and the generation of systemic immunity. Here, we review the interplay of RT and the tumour microenvironment and the rationale for combining SABR with immunomodulatory agents to generate systemic immunity and improve outcomes. THE INTERPLAY OF RADIOTHERAPY WITH THE TUMOUR MICROENVIRONMENTIt is estimated that radiotherapy (RT) is required in the treatment of over 50% of all patients with cancer. 1,2 The focus of radiobiology over previous decades has been on the direct cytoreductive effect that RT exerts on cancer cells by inducing DNA damage and only relatively recently have the effects of RT on tumour vasculature, stroma and the immune system received more attention. RT is known to have a number of effects on the generation of tumour-specific immunity, which include enhanced antigen release, expression of Natural killer receptor G2D (NKG2D) ligands, production of Type I Interferon (IFN) and complement, increased major histocompatibility complex and neoantigen expression and the induction of immunogenic cell death (ICD). [3][4][5][6][7][8][9]

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“…Radiotherapy is one of the most effective methods for the treatment of cancer (Njeh 2008) with an estimate of 52% of cancer patients benefitting from it (Delaney et al 2005). With the aging population, cancer incidence and mortality are expected to increase (Yancik and Ries 2004).…”

Section: Introductionmentioning

confidence: 99%

The influence of automation on tumor contouring

et al. 2017

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Fully or semi-automatic contouring tools are increasingly being used in the tumor contouring task for radiotherapy. While the fully automatic contouring tools have not reached sufficient efficiency, the semi-automatic contouring tools balance more effectively between the human interaction and automation. This study evaluates the influences of a semi-automation contouring tool, called between-slice interpolation, on the resulting contours and the contouring process. The tumor contouring study was conducted on three patient cases with five physicians in a naturalistic setting. The contouring task consisted of initiating the 2D contour manually or with the interpolation tool and correcting that initial contour. The similarity of the resulting contours was pairwise measured within the manual or the interpolated category. Interactions with the software were recorded, and variations in the contouring workflows steps were compared. Results indicated that using the between-slice interpolation tool for creating the initial contour, instead of initiating it manually, influenced both the contouring process and outcomes. First, it was identified that contours initiated by the interpolation tool showed an increased similarity among themselves compared to the manually initiated contours. At the same time, influences to the resulting contours were below clinical relevance, and toward the desired direction-improved consistency of contours. Second, when interpolation was used, in two cases out of three, the average contouring time also decreased significantly. Therefore, the use of such an automation tool can be encouraged.

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The role of radiotherapy in cancer treatment

Cited by 1,333 publications

References 24 publications

Prescription of Cancer Treatment Modalities in Developing Countries: Results from a Multi-Centre Observational Study

Prescription of Cancer Treatment Modalities in Developing Countries: Results from a Multi-Centre Observational Study

Stereotactic ablative radiotherapy and immunotherapy combinations: turning the future into systemic therapy?

The influence of automation on tumor contouring

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