Study the relationship of endothelial damage / dysfunction due to occupational exposure to low dose ionizing radiation versus high dose exposure during radiotherapy

Perirenal schwannoma mimicking a renal mass: A diagnostic pitfall - Case report

Perirenal schwannomas are rare benign tumors that may radiologically mimic renal malignancies. We report the case of a 39-year-old asymptomatic woman with an incidentally discovered perirenal mass initially suspected to be renal cancer. Intraoperatively, the lesion appeared well-encapsulated and extrarenal. Complete excision was performed, sparing the kidney. Histopathological analysis confirmed the diagnosis of benign schwannoma. This case highlights the diagnostic challenge of perirenal schwannomas and emphasizes the importance of intraoperative assessment and histological confirmation to avoid unnecessary nephrectomy.

Clinical Guidelines for the Prevention and Treatment of Radiation-induced Bladder Injury

Radiation-induced bladder injury is a common complication after pelvic radiotherapy. Few studies exist on diagnosing and treating radiation-induced bladder injury, with no established guidelines or consensus in China or internationally. Clinical physicians' diagnosis and treatment of radiation-induced bladder injury are primarily based on their own clinical experience, and there is an urgent need for unified guidelines to standardize clinical diagnosis and treatment. Therefore, the Chinese Radiation Therapy Oncology Group, China Anti-Cancer Association Tumor Support Therapy Committee, and China Anti-Cancer Association Tumor Radiation Protection Committee gathered experts to develop Chinese clinical practice guidelines, guiding diagnosing and treating radiation-induced bladder injury. The development of these guidelines adopted the grading system of evidence quality and recommendation strength (GRADE).

Tissue Reactions and Mechanism in Cardiovascular Diseases Induced by Radiation

The long-term survival rate of cancer patients has been increasing as a result of advances in treatments and precise medical management. The evidence has accumulated that the incidence and mortality of non-cancer diseases have increased along with the increase in survival time and long-term survival rate of cancer patients after radiotherapy. The risk of cardiovascular disease as a radiation late effect of tissue damage reactions is becoming a critical challenge and attracts great concern. Epidemiological research and clinical trials have clearly shown the close association between the development of cardiovascular disease in long-term cancer survivors and radiation exposure. Experimental biological data also strongly supports the above statement. Cardiovascular diseases can occur decades post-irradiation, and from initiation and development to illness, there is a complicated process, including direct and indirect damage of endothelial cells by radiation, acute vasculitis with neutrophil invasion, endothelial dysfunction, altered permeability, tissue reactions, capillary-like network loss, and activation of coagulator mechanisms, fibrosis, and atherosclerosis. We summarize the most recent literature on the tissue reactions and mechanisms that contribute to the development of radiation-induced cardiovascular diseases (RICVD) and provide biological knowledge for building preventative strategies.

Tumor Volume Regression during and after Radiochemotherapy: A Macroscopic Description

Tumor volume regression during and after chemo and radio therapy is a useful information for clinical decisions. Indeed, a quantitative, patient oriented, description of the response to treatment can guide towards the modification of the scheduled doses or the evaluation of the best time for surgery. We propose a macroscopic algorithm which permits to follow quantitatively the time evolution of the tumor volume during and after radiochemotherapy. The method, initially validated with different cell-lines implanted in mice, is then successfully applied to the available data for partially responding and complete recovery patients.

Understanding Molecular Mechanisms and Identifying Key Processes in Chronic Radiation Cystitis

Chronic radiation cystitis (CRC) is a consequence of pelvic radiotherapy and affects 5–10% of patients. The pathology of CRC is without curative treatment and is characterized by incontinence, pelvic pain and hematuria, which severely degrades patients’ quality of life. Current management strategies rely primarily on symptomatic measures and have certain limitations. Thanks to a better understanding of the pathophysiology of radiation cystitis, studies targeting key manifestations such as inflammation, neovascularization and cell atrophy have emerged and are promising avenues for future treatment. However, the mechanisms of CRC are still better described in animal models than in human models. Preclinical studies conducted to elucidate the pathophysiology of CRC use distinct models and are most often limited to specific processes, such as fibrosis, vascular damage and inflammation. This review presents a synthesis of experimental studies aimed at improving our understanding of the molecular mechanisms at play and identifying key processes in CRC.