Update on Results of Multifield Conformal Radiation Therapy of Non—Small-Cell Lung Cancer Using Multileaf Collimated Beams

Inhalation delivery of manganese superoxide dismutase-plasmid/liposomes protects the murine lung from irradiation damage

“…[1][2][3][4][5][6] Acute radiation pneumonitis, subacute pulmonary diffusion defects, and late radiation fibrosis remain significant complications to the development of more effective radiation treatments. 5,6 Studies of lung toxicity have documented the importance of ionizing radiation dose fraction size, total dose, time course of delivery of fractionated radiotherapy, and the significant factor of volume of lung irradiated.…”

“…3,5,6 Modern techniques of multifield conformal radiotherapy 1,2 and intensity modulated radiotherapy (IMRT) 7 have facilitated precise delivery of the high dose to tumor volumes that are now precisely defined by CT, MRI, and PET scanning; 7 however, these new modalities also deliver significant doses to normal tissues in the transit volume, which is the normal tissue through which the irradiation passes during irradiation of the tumor, predominantly normal lung. 2,3,5,6 Chemotherapy drugs including Taxol, Carboplatinum, and Gemcitabine used for both primary tumor radiosensitization and to treat microscopic metastatic disease also sensitize normal lung to radiation damage. 2,8 Since most lung and all esophageal cancers are central mediastinal in anatomic location, transit volumes involving both lungs are common in radiotherapy treatment plans.…”

“…2,3,5,6 Chemotherapy drugs including Taxol, Carboplatinum, and Gemcitabine used for both primary tumor radiosensitization and to treat microscopic metastatic disease also sensitize normal lung to radiation damage. 2,8 Since most lung and all esophageal cancers are central mediastinal in anatomic location, transit volumes involving both lungs are common in radiotherapy treatment plans. [1][2][3][9][10][11] Dose escalation protocols to attempt to derive local control in over 30% of patients with gross tumor are rarely possible due to lung toxicity.…”

“…2,8 Since most lung and all esophageal cancers are central mediastinal in anatomic location, transit volumes involving both lungs are common in radiotherapy treatment plans. [1][2][3][9][10][11] Dose escalation protocols to attempt to derive local control in over 30% of patients with gross tumor are rarely possible due to lung toxicity. 2,3,5,6 A biological response modifier approach toward decreasing pulmonary toxicity would be valuable to facilitate new improvements in radiation treatment.…”

“…[1][2][3][9][10][11] Dose escalation protocols to attempt to derive local control in over 30% of patients with gross tumor are rarely possible due to lung toxicity. 2,3,5,6 A biological response modifier approach toward decreasing pulmonary toxicity would be valuable to facilitate new improvements in radiation treatment. We have demonstrated that organ-specific (lung, [12][13][14][15][16] esophagus, [17][18][19][20] oral cavity, 21 bladder, 22 or intestine 23 ) introduction of the human manganese superoxide dismutase (MnSOD) transgene by plasmid/liposomes (MnSOD-PL) or viral vectors is associated with significant uptake, increased transgene mRNA and protein availability for 48-72 h after administration, and significant protection from ionizing radiation-induced acute and chronic organ injury.…”