Proton Therapy in Non-small Cell Lung Cancer

Opinion statementNon-small cell lung cancer (NSCLC) accounts for 85% of new lung cancer cases and has 5-year survival rates ranging from 92% in early-stage disease to as low as 13% in locally advanced cases. Radiation therapy is a key component in the treatment repertoire for NSCLC, where it is currently used alone or in combinations with chemotherapy and surgery. Despite the broad use of modern photon radiation techniques, as many as 25% of patients experience isolated locoregional recurrences, and toxicity has been proven to be a limiting factor in many cases. Proton beam therapy (PBT) has emerged as a potential solution to improve upon clinical outcomes in both early-stage and locally advanced disease. The proton beam allows for a sharp dose build-up and drop-off, which is particularly important in lung cancer where nearby structures include the heart, spinal cord, esophagus, and uninvolved lung. There are now numerous studies showing dosimetric advantages of PBT in early and locally advanced NSCLC, particularly in the heart and lung doses. Randomized data comparing clinical outcomes between proton and photon radiation are limited to a small number of studies. Despite early results suggesting improvements or at least comparable outcomes with PBT, the most recent randomized comparisons have failed to show significant differences in toxicity and local control between photon and proton therapy. As newer PBT techniques (e.g., intensity-modulated proton therapy) are increasingl...
Source: Current Treatment Options in Oncology - Category: Cancer & Oncology Source Type: research

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Publication date: Available online 2 August 2019Source: Practical Radiation OncologyAuthor(s): Robert T. Dess, Yilun Sun, Daniel G. Muenz, Peter A. Paximadis, Michael M. Dominello, Inga S. Grills, Larry L. Kestin, Benjamin Movsas, Kathryn J. Masi, Martha M. Matuszak, Jeffrey D. Radawski, Jean M. Moran, Lori J. Pierce, James A. Hayman, Matthew J. Schipper, Shruti Jolly, Michigan Radiation Oncology Quality ConsortiumAbstractPurposeThe heart has been identified as a potential significant organ at risk in patients with locally-advanced non-small cell lung cancer (NSCLC) treated with radiation. Practice patterns and radiation d...
Source: Practical Radiation Oncology - Category: Cancer & Oncology Source Type: research
This article summarizes the milestones in the development of camrelizumab leading to this first approval for classical Hodgkin lymphoma.
Source: Drugs - Category: Drugs & Pharmacology Source Type: research
Publication date: Available online 25 June 2019Source: Practical Radiation OncologyAuthor(s): Sarah Z. Hazell, Russell K. Hales, William T. Hrinivich, Kristy Ford, Ken Kang-Hsin Wang, Todd R. McNutt, Peijin Han, Lori J. Anderson, Adam C. Ferro, Joseph Moore, Khinh Ranh VoongAbstractIntroductionNon-homogeneous dose optimization (NHDO) is exploited in stereotactic body radiotherapy (SBRT) to increase dose delivery to the tumor and allow rapid dose fall-off to surrounding normal tissues. We investigate changes in plan quality when NHDO is applied to conventionally-fractionated inverse-planned radiation (CF-RT) plans, in patie...
Source: Practical Radiation Oncology - Category: Cancer & Oncology Source Type: research
ConclusionsVMAT is now widely available, and high-quality VMAT plans that incorporate cardiac substructures into the optimization process can provide overall improvements in dose to OARs and, in particular, substantial sparing of critical cardiac structures. IMPT provides some incremental dosimetric improvements beyond cardiac-optimized VMAT, the clinical significance of which remains uncertain.
Source: Practical Radiation Oncology - Category: Cancer & Oncology Source Type: research
This article summarizes the milestones in the development of erdafitinib leading to this first approval for the treatment of urothelial carcinoma.
Source: Drugs - Category: Drugs & Pharmacology Source Type: research
Abstract Starting from their role exerted on osteoblast and osteoclast differentiation and activity pathways, microRNAs (miRNAs) have been recently identified as regulators of different processes in bone homeostasis. For this purpose, in a recent review, we highlighted, as deregulated miRNAs could be involved in different bone diseases such as osteoporosis. In addition, recent studies supported the concept that osteoporosis-induced bone alterations might offer a receptive site for cancer cells to form bone metastases, However, to date, no data on specific-shared miRNAs between osteoporosis and bone metastases have...
Source: Cellular and Molecular Life Sciences : CMLS - Category: Cytology Authors: Tags: Cell Mol Life Sci Source Type: research
Abstract PURPOSE: To identify published normal tissue complication probability (NTCP) models suitable for patient-specific dose-prescription in locally advanced non-small cell lung cancer (LA-NSCLC) through in-house validation. MATERIAL AND METHODS: From eight previously published candidate NTCP models (≥grade 2 acute esophagitis and radiation pneumonitis; AE2, RP2), patient-specific dose-responses were calculated using model variables and fractionation-corrected doses for 241 LA-NSCLC patients treated with chemo-IMRT to 50-80 Gy@1.8-2.0 Gy between 2004 and 2014 (AE2/RP2 rate: 50%/12%). A model was jud...
Source: Radiotherapy and Oncology : journal of the European Society for Therapeutic Radiology and Oncology - Category: Radiology Authors: Tags: Radiother Oncol Source Type: research
ΜicroRNA‑889 plays a suppressive role in cell proliferation and invasion by directly targeting TAB1 in non‑small cell lung cancer. Mol Med Rep. 2019 May 15;: Authors: Dong Z, Li B, Wang X Abstract MicroRNAs (miRNAs) are frequently reported to be aberrantly expressed in non‑small cell lung cancer (NSCLC) and are closely associated with aggressive tumor phenotypes. Hence, identification of cancer‑related miRNAs in NSCLC may be helpful for improving the cure rate of NSCLC treatments. miR‑889 has been demonstrated to be a novel cancer‑associated miRNA that is aberrantly expressed and plays a...
Source: Molecular Medicine Reports - Category: Molecular Biology Tags: Mol Med Rep Source Type: research
Background and objective Current research shows that platelet to lymphocyte ratio (PLR) has important prognostic value in renal cell carcinoma, esophageal cancer, gastric cancer, liver cancer and colon cancer. The aim of the study is to evaluate the prognostic value of PLR in non-small cell lung cancer (NSCLC) through meta-analysis. Methods Literature search for PubMed, EMBASE, Web of Science, Medline, Cochrane Library, China National Knowledge Internet (CNKI), China Biomedical Medicine disc (CBMdisc), VIP, Wanfang Database using computer electronic system to study the association between PLR and overall survival (OS) and ...
Source: Chinese Journal of Lung Cancer - Category: Cancer & Oncology Source Type: research
ConclusionsVMAT is now widely available, and high-quality VMAT plans that incorporate the cardiac substructures into the optimization process can provide overall improvements in doses to OARs and in particular substantial sparing of critical cardiac structures. IMPT provides some incremental dosimetric improvements beyond cardiac-optimized VMAT, the clinical significance of which remains uncertain.
Source: Practical Radiation Oncology - Category: Cancer & Oncology Source Type: research
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