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Ratosa I, Montero A, Ciervide R, Alvarez B, García-Aranda M, Valero J, Chen-Zhao X, Lopez M, Zucca D, Hernando O, Sánchez E, de la Casa MA, Alonso R, Fernandez-Leton P, Rubio C. Ultra-hypofractionated one-week locoregional radiotherapy for patients with early breast cancer: Acute toxicity results. Clin Transl Radiat Oncol 2024; 46:100764. [PMID: 38516338 PMCID: PMC10955656 DOI: 10.1016/j.ctro.2024.100764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 02/26/2024] [Accepted: 03/11/2024] [Indexed: 03/23/2024] Open
Abstract
Purpose Moderate hypofractionated radiotherapy is the standard of care for all patients with breast cancer, irrespective of stage or prior treatments. While extreme hypofractionation is accepted for early-stage tumours, its application in irradiating locoregional lymph nodes remains controversial. Materials and methods A prospective registry analysis from July 2020 to September 2023 included 276 patients with early-stage breast cancer treated with one-week ultra-hypofractionation (UHF) at 26 Gy in 5 fractions on the whole breast (58.3 %) or thoracic wall (41.7 %) and ipsilateral regional lymph nodes and simultaneous integrated boost (58.3 %). Primary endpoint was assessment of acute adverse events (AEs). Secondarily, onset of early-delayed toxicity was assessed. A minimum 6-month follow-up was required for assessing potential treatment-related early-delayed complications. Acute or late complications attributable to treatment were assessed at inclusion using the Common Terminology Criteria for Adverse Events (CTCAE) v5.0 criteria. Results With a median follow-up of 19 months (range 1-49 months), 159 (57.6 %) patients reported AEs, predominantly grade (G) 1 (n = 139, 50.4 %) and G2 (n = 20, 7.8 %). Skin acute toxicity was common (G1/2: 134, G3: 14), while breast oedema occurred in 10 patients (G1: 9, G2: 1), and 15.9 % reported breast pain (G1: 42, G2: 2). Ipsilateral arm oedema was observed in 1.8 % patients. For patients with a follow-up beyond 6 months (n = 213), 23.4 % patients reported G1/G2 skin AEs, 8.8 % had G1/G2 breast/chest wall oedema, and 8.9 % experienced arm lymphedema. There were no cases of brachial plexopathy or G3 toxicity in this group of patients. Conclusions One-week UHF adjuvant locoregional radiation is well-tolerated, displaying low-toxicity profiles comparable to other studies using similar irradiation schedules.
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Affiliation(s)
- Ivica Ratosa
- Division of Radiation Oncology, Institute of Oncology Ljubljana, Ljubljana, Slovenia
- Medical Faculty, University of Ljubljana, Ljubljana, Slovenia
- Department of Radiation Oncology, HM Hospitales, Madrid, Spain
| | - Angel Montero
- Department of Radiation Oncology, HM Hospitales, Madrid, Spain
- Facultad de Ciencias de la Salud, Universidad Camilo José Cela, Madrid, Spain
| | - Raquel Ciervide
- Department of Radiation Oncology, HM Hospitales, Madrid, Spain
| | - Beatriz Alvarez
- Department of Radiation Oncology, HM Hospitales, Madrid, Spain
| | | | | | - Xin Chen-Zhao
- Department of Radiation Oncology, HM Hospitales, Madrid, Spain
| | - Mercedes Lopez
- Department of Radiation Oncology, HM Hospitales, Madrid, Spain
| | - Daniel Zucca
- Department of Medical Physics, HM Hospitales, Madrid, Spain
| | - Ovidio Hernando
- Department of Radiation Oncology, HM Hospitales, Madrid, Spain
| | - Emilio Sánchez
- Department of Radiation Oncology, HM Hospitales, Madrid, Spain
| | | | - Rosa Alonso
- Department of Radiation Oncology, HM Hospitales, Madrid, Spain
| | | | - Carmen Rubio
- Department of Radiation Oncology, HM Hospitales, Madrid, Spain
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Rodríguez MCR, Chen-Zhao X, Hernando O, Flamarique S, Fernández-Letón P, Campo M, López M, Rodríguez M, Zucca D, Martínez D, Sánchez-Saugar E, Mañeru F, Ruiz-Zorrilla JG, de Acilu PG, Valero J, Montero A, Ciérvide R, Alvarez B, García-Aranda M, Alonso R, de la Casa MA, Alonso L, Nuñez M, Martí J, Arias F. SBRT-SG-01: final results of a prospective multicenter study on stereotactic body radiotherapy for liver metastases. Clin Transl Oncol 2024:10.1007/s12094-024-03403-w. [PMID: 38431539 DOI: 10.1007/s12094-024-03403-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 02/01/2024] [Indexed: 03/05/2024]
Abstract
OBJECTIVE This study aimed to assess the efficacy and tolerability of stereotactic body radiation therapy (SBRT) for the treatment of liver metastases. METHODS Patients with up to 5 liver metastases were enrolled in this prospective multicenter study and underwent SBRT. Efficacy outcomes included in-field local control (LC), progression-free survival (PFS), and overall survival (OS). Acute and late toxicities were evaluated using CTCAE v.4.0. RESULTS A total of 52 patients with 105 liver metastases were treated between 2015 and 2018. The most common primary tumor was colorectal cancer (72% of cases). Liver metastases were synchronous with the primary tumor diagnosis in 24 patients (46.2%), and 21 patients (40.4%) presented with other extrahepatic oligometastases. All patients underwent intensity-modulated radiation therapy (IMRT)/volumetric-modulated arc therapy (VMAT) with image-guided radiation therapy (IGRT) and respiratory gating, and a minimum biologically effective dose (BED10Gy) of 100 Gy was delivered to all lesions. With a median follow-up of 23.1 months (range: 13.4-30.9 months) since liver SBRT, the median actuarial local progression-free survival (local-PFS) was not reached. The actuarial in-field LC rates were 84.9% and 78.4% at 24 and 48 months, respectively. The median actuarial liver-PFS and distant-PFS were 11 and 10.8 months, respectively. The actuarial median overall survival (OS) was 27.7 months from SBRT and 52.5 months from metastases diagnosis. Patients with lesion diameter ≤ 5 cm had significantly better median liver-PFS (p = 0.006) and OS (p = 0.018). No acute or late toxicities of grade ≥ 3 were observed. CONCLUSIONS This prospective multicenter study confirms that liver SBRT is an effective alternative for the treatment of liver metastases, demonstrating high rates of local control and survival while maintaining a low toxicity profile.
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Affiliation(s)
| | - Xin Chen-Zhao
- Radiation Oncology, Hospital Universitario HM Puerta del Sur, HM Hospitales, Madrid, Spain
| | - Ovidio Hernando
- Radiation Oncology, Hospital Universitario HM Sanchinarro, HM Hospitales, Madrid, Spain
| | - Sonia Flamarique
- Radiation Oncology, Complejo Hospitalario de Navarra, Navarra, Spain
| | - Pedro Fernández-Letón
- Medical Physics, Hospital Universitario HM Sanchinarro, HM Hospitales, Madrid, Spain
| | - Maider Campo
- Radiation Oncology, Complejo Hospitalario de Navarra, Navarra, Spain
| | - Mercedes López
- Radiation Oncology, Hospital Universitario HM Sanchinarro, HM Hospitales, Madrid, Spain
| | - Maitane Rodríguez
- Radiation Oncology, Complejo Hospitalario de Navarra, Navarra, Spain
| | - Daniel Zucca
- Medical Physics, Hospital Universitario HM Sanchinarro, HM Hospitales, Madrid, Spain
| | - Daniel Martínez
- Medical Physics, Complejo Hospitalario de Navarra, Navarra, Spain
| | - Emilio Sánchez-Saugar
- Radiation Oncology, Hospital Universitario HM Sanchinarro, HM Hospitales, Madrid, Spain
| | - Fernando Mañeru
- Medical Physics, Complejo Hospitalario de Navarra, Navarra, Spain
| | | | - Paz García de Acilu
- Medical Physics, Hospital Universitario HM Puerta del Sur, HM Hospitales, Madrid, Spain
| | - Jeannette Valero
- Radiation Oncology, Hospital Universitario HM Sanchinarro, HM Hospitales, Madrid, Spain
| | - Angel Montero
- Radiation Oncology, Hospital Universitario HM Sanchinarro, HM Hospitales, Madrid, Spain
| | - Raquel Ciérvide
- Radiation Oncology, Hospital Universitario HM Sanchinarro, HM Hospitales, Madrid, Spain
| | - Beatriz Alvarez
- Radiation Oncology, Hospital Universitario HM Sanchinarro, HM Hospitales, Madrid, Spain
| | - Mariola García-Aranda
- Radiation Oncology, Hospital Universitario HM Sanchinarro, HM Hospitales, Madrid, Spain
| | - Rosa Alonso
- Radiation Oncology, Hospital Universitario HM Puerta del Sur, HM Hospitales, Madrid, Spain
| | | | - Leyre Alonso
- Medical Physics, Hospital Universitario HM Sanchinarro, HM Hospitales, Madrid, Spain
| | - Mónica Nuñez
- Radiation Oncology, Hospital Universitario HM Sanchinarro, HM Hospitales, Madrid, Spain
| | - Jaime Martí
- Medical Physics, Hospital Universitario HM Sanchinarro, HM Hospitales, Madrid, Spain
| | - Fernando Arias
- Radiation Oncology, Complejo Hospitalario de Navarra, Navarra, Spain
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Montero A, Chen-Zhao X, Ciérvide R, Álvarez B, Prado A, López M, Sánchez E, Hernando O, de la Casa MA, García-Aranda M, Valero J, Alonso R, Fernández-Letón P, Rubio C. Moderate hypofractionated radiation therapy and pathologic response for soft tissue sarcomas (STS) of limbs and trunk: experience from a tertiary cancer center. Clin Transl Oncol 2024; 26:204-213. [PMID: 37277526 DOI: 10.1007/s12094-023-03237-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 05/28/2023] [Indexed: 06/07/2023]
Abstract
BACKGROUND Preoperative radiation therapy following by limb-sparing or conservative surgery is a standard approach for limb and trunk STS. Data supporting hypofractionated radiotherapy schedules are scarce albeit biological sensitivity of STS to radiation would justify it. We sought to evaluate the impact of moderate hypofractionation on pathologic response and its influence on oncologic outcomes. MATERIAL AND METHODS From October 2018 to January 2023, 18 patients with limb or trunk STS underwent preoperative radiotherapy at a median dose of 52.5 Gy (range 49.5-60 Gy) in 15 fractions of 3.5 Gy (3.3-4 Gy) with or without neoadjuvant chemotherapy. A favorable pathologic response (fPR) was considered as ≥ 90% tumor necrosis on specimen examination. RESULTS All patients completed planned preoperative radiotherapy. Eleven patients (61.1%) achieved a fPR, and 7 patients (36.8%) a complete pathologic response with total disappearance of tumor cells. Nine patients (47%) developed grade 1-2 acute skin toxicity, and 7 patients (38.8%) had wound complications on follow-up. With a median follow-up of 14 months (range 1-40), no cases of local relapse were observed, and actuarial 3-year overall survival (OS) and distant metastases-free survival (DMFS) are 87% and 76.4%, respectively. In the univariate analysis, the presence of a favorable pathologic response (fPR) was associated with improved 3-year OS (100% vs. 56.03%, p = 0.058) and 3-year DMFS (86.91% vs. 31.46%, p = 0.002). Moreover, both complete or partial RECIST response and radiological stabilization of the tumor lesion showed a significant association with higher rates of 3-year distant metastasis-free survival (DMFS) (83% vs. 83% vs. 56%, p < 0.001) and 3-year overall survival (OS) (100% vs. 80% vs. 0, p = 0.002). CONCLUSIONS Preoperative moderate hypofractionated radiation treatment for STS is feasible and well tolerated and associates encouraging rates of pathologic response that could have a favorable impact on final outcomes.
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Affiliation(s)
- Angel Montero
- Department of Radiation Oncology, Centro Integral Oncológico Clara Campal (C.I.O.C.C.), HM Hospitales, Calle Oña 10, 28050, Madrid, Spain.
- Facultad de Ciencias de la Salud, Universidad Camilo José Cela, Madrid, Spain.
| | - Xin Chen-Zhao
- Department of Radiation Oncology, Centro Integral Oncológico Clara Campal (C.I.O.C.C.), HM Hospitales, Calle Oña 10, 28050, Madrid, Spain
| | - Raquel Ciérvide
- Department of Radiation Oncology, Centro Integral Oncológico Clara Campal (C.I.O.C.C.), HM Hospitales, Calle Oña 10, 28050, Madrid, Spain
| | - Beatriz Álvarez
- Department of Radiation Oncology, Centro Integral Oncológico Clara Campal (C.I.O.C.C.), HM Hospitales, Calle Oña 10, 28050, Madrid, Spain
| | - Alejandro Prado
- Department of Medical Physics, Centro Integral Oncológico Clara Campal (C.I.O.C.C.), HM Hospitales, Madrid, Spain
| | - Mercedes López
- Department of Radiation Oncology, Centro Integral Oncológico Clara Campal (C.I.O.C.C.), HM Hospitales, Calle Oña 10, 28050, Madrid, Spain
| | - Emilio Sánchez
- Department of Radiation Oncology, Centro Integral Oncológico Clara Campal (C.I.O.C.C.), HM Hospitales, Calle Oña 10, 28050, Madrid, Spain
| | - Ovidio Hernando
- Department of Radiation Oncology, Centro Integral Oncológico Clara Campal (C.I.O.C.C.), HM Hospitales, Calle Oña 10, 28050, Madrid, Spain
| | - Miguel Angel de la Casa
- Department of Medical Physics, Centro Integral Oncológico Clara Campal (C.I.O.C.C.), HM Hospitales, Madrid, Spain
| | - Mariola García-Aranda
- Department of Radiation Oncology, Centro Integral Oncológico Clara Campal (C.I.O.C.C.), HM Hospitales, Calle Oña 10, 28050, Madrid, Spain
| | - Jeannette Valero
- Department of Radiation Oncology, Centro Integral Oncológico Clara Campal (C.I.O.C.C.), HM Hospitales, Calle Oña 10, 28050, Madrid, Spain
| | - Rosa Alonso
- Department of Radiation Oncology, Centro Integral Oncológico Clara Campal (C.I.O.C.C.), HM Hospitales, Calle Oña 10, 28050, Madrid, Spain
| | - Pedro Fernández-Letón
- Department of Medical Physics, Centro Integral Oncológico Clara Campal (C.I.O.C.C.), HM Hospitales, Madrid, Spain
| | - Carmen Rubio
- Department of Radiation Oncology, Centro Integral Oncológico Clara Campal (C.I.O.C.C.), HM Hospitales, Calle Oña 10, 28050, Madrid, Spain
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Gomis Sellés E, Montero A, Arenas M. Making Radiation Oncology specialty more attractive to young medical graduates: pulling back the invisibility curtain. Clin Transl Oncol 2023; 25:3312-3318. [PMID: 37378794 DOI: 10.1007/s12094-023-03257-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 06/14/2023] [Indexed: 06/29/2023]
Abstract
PURPOSE Radiation Oncology is one of the least-known medical specialties for young graduates at the end of their studies. An in-depth analysis of the strengths and weaknesses of the Radiation Oncology visibility, the training plan, and why it is less attractive for new medical residents during the last years appears as the initial need to turn out this lack of knowledge. MATERIALS AND METHODS An anonymous pilot survey of 24 questions addressed to specialists in-training in Radiation Oncology in Spain during August and September of 2022. RESULTS A total of 50 in-training radiation oncologists answered the questionnaire and 90% of them believe that a lack of knowledge, mainly at the School of Medicine, was a major reason why choosing Radiation Oncology was unattractive. All responders were satisfied by choosing Radiation Oncology, and 76% were in favor of extending the residency to 5 years to improve their training. Research activity was considered essential (78%) to complete their training. CONCLUSION Increasing the presence of Radiation Oncology at the School of Medicine may be one solution to achieve greater attractiveness among future residents. Likewise, extending the training period to five years could help to enhance the learning of all radiotherapy techniques while promoting clinical research.
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Affiliation(s)
- Elías Gomis Sellés
- Department of Radiation Oncology, University Hospital Virgen del Rocío, Biomedical Institute of Seville (IBIS)/CSIC/University of Seville, Seville, Spain.
| | - Angel Montero
- Department of Radiation Oncology, HM Hospitales, Universidad Camilo José Cela, Facultad de Ciencias de la Salud, Madrid, Spain
| | - Meritxell Arenas
- Department of Radiation Oncology, Institut d'Investigació Sanitària Pere Virgili, Universitat Rovira i Virgili, Facultat de Medicina i Ciències de la Salut, Hospital Universitari de Sant Joan, 43204, Reus, Spain
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5
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Hernando-Requejo O, Chen X, López M, Sánchez E, García J, García P, Alonso R, Montero A, Ciervide R, Álvarez B, Zucca D, García Aranda M, Valero J, Fernández Letón P, Rubio C. Real-world effectiveness and safety of stereotactic body radiotherapy for liver metastases with different respiratory motion management techniques. Strahlenther Onkol 2023; 199:1000-1010. [PMID: 37728734 DOI: 10.1007/s00066-023-02147-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 08/13/2023] [Indexed: 09/21/2023]
Abstract
PURPOSE Stereotactic body radiotherapy (SBRT) has been firmly established as a treatment choice for patients with oligometastases, as it has demonstrated both safety and efficacy by consistently achieving high rates of local control. Moreover, it offers potential survival benefits for carefully selected patients in real-world clinical settings. METHODS Between January 2008 and May 2020, a total of 149 patients (with 414 liver metastases) received treatment. The Active Breathing Coordinator device was used for 68 patients, while respiratory gating was used for 65 and abdominal compression was used for 16 patients. The most common histological finding was colorectal adenocarcinoma, with 37.6% of patients having three or more metastases, and 18% having two metastases. The prescribed dose ranged from 36 to 60 Gy, delivered in 3-5 fractions. RESULTS Local control rates at 2 and 3 years were 76.1% and 61.2%, respectively, with no instances of local recurrence after 3 years. Factors negatively impacting local control included colorectal histology, lower prescribed dose, and the occurrence of new liver metastases. The median overall survival from SBRT was 32 months, with the presence of metastases outside the liver and the development of new liver metastases after SBRT affecting survival. The median disease-free survival was 10 months. No substantial differences in both local control and survival were observed between the respiratory motion control techniques employed. Treatment tolerance was excellent, with only one patient experiencing acute grade IV thrombocytopenia and two patients suffering from ≥ grade II chronic toxicity. CONCLUSION For radical management of single or multiple liver metastases, SBRT is an effective and well-tolerated treatment option. Regardless of the technology employed, experienced physicians can achieve similarly positive outcomes. However, additional studies are required to elucidate prognostic factors that can facilitate improved patient selection.
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Affiliation(s)
- O Hernando-Requejo
- Radiation Oncology Department, University Hospital HM Puerta del Sur, Madrid, Spain.
- Radiation Oncology Department, University Hospital HM Sanchinarro, Madrid, Spain.
| | - X Chen
- Radiation Oncology Department, University Hospital HM Puerta del Sur, Madrid, Spain
| | - M López
- Radiation Oncology Department, University Hospital HM Sanchinarro, Madrid, Spain
| | - E Sánchez
- Radiation Oncology Department, University Hospital HM Sanchinarro, Madrid, Spain
| | - J García
- Radiation Physics Department, University Hospital HM Puerta del Sur, Madrid, Spain
| | - P García
- Radiation Physics Department, University Hospital HM Puerta del Sur, Madrid, Spain
| | - R Alonso
- Radiation Oncology Department, University Hospital HM Puerta del Sur, Madrid, Spain
| | - A Montero
- Radiation Oncology Department, University Hospital HM Sanchinarro, Madrid, Spain
| | - R Ciervide
- Radiation Oncology Department, University Hospital HM Sanchinarro, Madrid, Spain
| | - B Álvarez
- Radiation Oncology Department, University Hospital HM Sanchinarro, Madrid, Spain
| | - D Zucca
- Radiation Physics Department, University Hospital HM Sanchinarro, Madrid, Spain
| | - M García Aranda
- Radiation Oncology Department, University Hospital HM Sanchinarro, Madrid, Spain
| | - J Valero
- Radiation Oncology Department, University Hospital HM Sanchinarro, Madrid, Spain
| | - P Fernández Letón
- Radiation Physics Department, University Hospital HM Sanchinarro, Madrid, Spain
| | - C Rubio
- Radiation Oncology Department, University Hospital HM Puerta del Sur, Madrid, Spain
- Radiation Oncology Department, University Hospital HM Sanchinarro, Madrid, Spain
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Borau C, Wertheim KY, Hervas-Raluy S, Sainz-DeMena D, Walker D, Chisholm R, Richmond P, Varella V, Viceconti M, Montero A, Gregori-Puigjané E, Mestres J, Kasztelnik M, García-Aznar JM. A multiscale orchestrated computational framework to reveal emergent phenomena in neuroblastoma. Comput Methods Programs Biomed 2023; 241:107742. [PMID: 37572512 DOI: 10.1016/j.cmpb.2023.107742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 07/19/2023] [Accepted: 07/31/2023] [Indexed: 08/14/2023]
Abstract
Neuroblastoma is a complex and aggressive type of cancer that affects children. Current treatments involve a combination of surgery, chemotherapy, radiotherapy, and stem cell transplantation. However, treatment outcomes vary due to the heterogeneous nature of the disease. Computational models have been used to analyse data, simulate biological processes, and predict disease progression and treatment outcomes. While continuum cancer models capture the overall behaviour of tumours, and agent-based models represent the complex behaviour of individual cells, multiscale models represent interactions at different organisational levels, providing a more comprehensive understanding of the system. In 2018, the PRIMAGE consortium was formed to build a cloud-based decision support system for neuroblastoma, including a multi-scale model for patient-specific simulations of disease progression. In this work we have developed this multi-scale model that includes data such as patient's tumour geometry, cellularity, vascularization, genetics and type of chemotherapy treatment, and integrated it into an online platform that runs the simulations on a high-performance computation cluster using Onedata and Kubernetes technologies. This infrastructure will allow clinicians to optimise treatment regimens and reduce the number of costly and time-consuming clinical trials. This manuscript outlines the challenging framework's model architecture, data workflow, hypothesis, and resources employed in its development.
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Affiliation(s)
- C Borau
- Multiscale in Mechanical and Biological Engineering (M2BE), Aragon Institute of Engineering Research (I3A), Mechanical Engineering Department, University of Zaragoza, Zaragoza, Spain.
| | - K Y Wertheim
- Department of Computer Science and InsigneoInstitute for In Silico Medicine, University of Sheffield, Sheffield, United Kingdom; Centre of Excellence for Data Science, Artificial Intelligence and Modelling and School of Computer Science, University of Hull, Kingston upon Hull, United Kingdom
| | - S Hervas-Raluy
- Multiscale in Mechanical and Biological Engineering (M2BE), Aragon Institute of Engineering Research (I3A), Mechanical Engineering Department, University of Zaragoza, Zaragoza, Spain
| | - D Sainz-DeMena
- Multiscale in Mechanical and Biological Engineering (M2BE), Aragon Institute of Engineering Research (I3A), Mechanical Engineering Department, University of Zaragoza, Zaragoza, Spain
| | - D Walker
- Department of Computer Science and InsigneoInstitute for In Silico Medicine, University of Sheffield, Sheffield, United Kingdom
| | - R Chisholm
- Department of Computer Science and InsigneoInstitute for In Silico Medicine, University of Sheffield, Sheffield, United Kingdom
| | - P Richmond
- Department of Computer Science and InsigneoInstitute for In Silico Medicine, University of Sheffield, Sheffield, United Kingdom
| | - V Varella
- Department of Industrial Engineering, Alma Mater Studiorum - University of Bologna, Bologna, Italy; Medical Technology Lab, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - M Viceconti
- Department of Industrial Engineering, Alma Mater Studiorum - University of Bologna, Bologna, Italy; Medical Technology Lab, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - A Montero
- Chemotargets SL, Baldiri Reixac 4, Parc Cientific de Barcelona (PCB), Barcelona, Spain
| | - E Gregori-Puigjané
- Chemotargets SL, Baldiri Reixac 4, Parc Cientific de Barcelona (PCB), Barcelona, Spain
| | - J Mestres
- Chemotargets SL, Baldiri Reixac 4, Parc Cientific de Barcelona (PCB), Barcelona, Spain
| | - M Kasztelnik
- ACC Cyfronet, AGH University of Science and Technology, Kraków, Poland
| | - J M García-Aznar
- Multiscale in Mechanical and Biological Engineering (M2BE), Aragon Institute of Engineering Research (I3A), Mechanical Engineering Department, University of Zaragoza, Zaragoza, Spain
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7
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Furuhama A, Kitazawa A, Yao J, Matos Dos Santos CE, Rathman J, Yang C, Ribeiro JV, Cross K, Myatt G, Raitano G, Benfenati E, Jeliazkova N, Saiakhov R, Chakravarti S, Foster RS, Bossa C, Battistelli CL, Benigni R, Sawada T, Wasada H, Hashimoto T, Wu M, Barzilay R, Daga PR, Clark RD, Mestres J, Montero A, Gregori-Puigjané E, Petkov P, Ivanova H, Mekenyan O, Matthews S, Guan D, Spicer J, Lui R, Uesawa Y, Kurosaki K, Matsuzaka Y, Sasaki S, Cronin MTD, Belfield SJ, Firman JW, Spînu N, Qiu M, Keca JM, Gini G, Li T, Tong W, Hong H, Liu Z, Igarashi Y, Yamada H, Sugiyama KI, Honma M. Evaluation of QSAR models for predicting mutagenicity: outcome of the Second Ames/QSAR international challenge project. SAR QSAR Environ Res 2023; 34:983-1001. [PMID: 38047445 DOI: 10.1080/1062936x.2023.2284902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 11/13/2023] [Indexed: 12/05/2023]
Abstract
Quantitative structure-activity relationship (QSAR) models are powerful in silico tools for predicting the mutagenicity of unstable compounds, impurities and metabolites that are difficult to examine using the Ames test. Ideally, Ames/QSAR models for regulatory use should demonstrate high sensitivity, low false-negative rate and wide coverage of chemical space. To promote superior model development, the Division of Genetics and Mutagenesis, National Institute of Health Sciences, Japan (DGM/NIHS), conducted the Second Ames/QSAR International Challenge Project (2020-2022) as a successor to the First Project (2014-2017), with 21 teams from 11 countries participating. The DGM/NIHS provided a curated training dataset of approximately 12,000 chemicals and a trial dataset of approximately 1,600 chemicals, and each participating team predicted the Ames mutagenicity of each trial chemical using various Ames/QSAR models. The DGM/NIHS then provided the Ames test results for trial chemicals to assist in model improvement. Although overall model performance on the Second Project was not superior to that on the First, models from the eight teams participating in both projects achieved higher sensitivity than models from teams participating in only the Second Project. Thus, these evaluations have facilitated the development of QSAR models.
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Affiliation(s)
- A Furuhama
- Division of Genetics and Mutagenesis (DGM), National Institute of Health Sciences (NIHS), Kawasaki, Japan
| | - A Kitazawa
- Division of Genetics and Mutagenesis (DGM), National Institute of Health Sciences (NIHS), Kawasaki, Japan
| | - J Yao
- Key Laboratory of Fluorine and Nitrogen Chemistry and Advanced Materials (Chinese Academy of Sciences), Shanghai Institute of Organic Chemistry, Chinese Academy of Sciences (SIOC, CAS), Shanghai, China
| | - C E Matos Dos Santos
- Department of Computational Toxicology and In Silico Innovations, Altox Ltd, São Paulo-SP, Brazil
| | - J Rathman
- MN-AM, Nuremberg, Germany/Columbus, OH, USA
| | - C Yang
- MN-AM, Nuremberg, Germany/Columbus, OH, USA
| | | | - K Cross
- In Silico Department, Instem, Conshohocken, PA, USA
| | - G Myatt
- In Silico Department, Instem, Conshohocken, PA, USA
| | - G Raitano
- Laboratory of Environmental Toxicology and Chemistry, Department of Environmental Health Sciences, Istituto di Ricerche Farmacologiche Mario Negri IRCCS (IRFMN), Milano, Italy
| | - E Benfenati
- Laboratory of Environmental Toxicology and Chemistry, Department of Environmental Health Sciences, Istituto di Ricerche Farmacologiche Mario Negri IRCCS (IRFMN), Milano, Italy
| | | | | | | | | | - C Bossa
- Environment and Health Department, Istituto Superiore di Sanità (ISS), Rome, Italy
| | - C Laura Battistelli
- Environment and Health Department, Istituto Superiore di Sanità (ISS), Rome, Italy
| | - R Benigni
- Environment and Health Department, Istituto Superiore di Sanità (ISS), Rome, Italy
- Alpha-PreTox, Rome, Italy
| | - T Sawada
- Faculty of Regional Studies, Gifu University, Gifu, Japan
- xenoBiotic Inc, Gifu, Japan
| | - H Wasada
- Faculty of Regional Studies, Gifu University, Gifu, Japan
| | - T Hashimoto
- Faculty of Regional Studies, Gifu University, Gifu, Japan
| | - M Wu
- Massachusetts Institute of Technology, Cambridge, MA, USA
| | - R Barzilay
- Massachusetts Institute of Technology, Cambridge, MA, USA
| | - P R Daga
- Simulations Plus, Lancaster, CA, USA
| | - R D Clark
- Simulations Plus, Lancaster, CA, USA
| | | | | | | | - P Petkov
- LMC - Bourgas University, Bourgas, Bulgaria
| | - H Ivanova
- LMC - Bourgas University, Bourgas, Bulgaria
| | - O Mekenyan
- LMC - Bourgas University, Bourgas, Bulgaria
| | - S Matthews
- Computational Pharmacology & Toxicology Laboratory, Discipline of Pharmacology, School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - D Guan
- Computational Pharmacology & Toxicology Laboratory, Discipline of Pharmacology, School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - J Spicer
- Computational Pharmacology & Toxicology Laboratory, Discipline of Pharmacology, School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - R Lui
- Computational Pharmacology & Toxicology Laboratory, Discipline of Pharmacology, School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Y Uesawa
- Department of Medical Molecular Informatics, Meiji Pharmaceutical University, Tokyo, Japan
| | - K Kurosaki
- Department of Medical Molecular Informatics, Meiji Pharmaceutical University, Tokyo, Japan
| | - Y Matsuzaka
- Department of Medical Molecular Informatics, Meiji Pharmaceutical University, Tokyo, Japan
| | - S Sasaki
- Department of Medical Molecular Informatics, Meiji Pharmaceutical University, Tokyo, Japan
| | - M T D Cronin
- School of Pharmacy and Biomolecular Sciences, Liverpool John Moores University, Liverpool, UK
| | - S J Belfield
- School of Pharmacy and Biomolecular Sciences, Liverpool John Moores University, Liverpool, UK
| | - J W Firman
- School of Pharmacy and Biomolecular Sciences, Liverpool John Moores University, Liverpool, UK
| | - N Spînu
- School of Pharmacy and Biomolecular Sciences, Liverpool John Moores University, Liverpool, UK
| | - M Qiu
- Evergreen AI, Inc, Toronto, Canada
| | - J M Keca
- Evergreen AI, Inc, Toronto, Canada
| | - G Gini
- Department of Electronics, Information and Bioengineering (DEIB), Politecnico di Milano, Milano, Italy
| | - T Li
- Division of Bioinformatics and Biostatistics, National Center for Toxicological Research, U.S. Food and Drug Administration (NCTR/FDA), Jefferson, AR, USA
| | - W Tong
- Division of Bioinformatics and Biostatistics, National Center for Toxicological Research, U.S. Food and Drug Administration (NCTR/FDA), Jefferson, AR, USA
| | - H Hong
- Division of Bioinformatics and Biostatistics, National Center for Toxicological Research, U.S. Food and Drug Administration (NCTR/FDA), Jefferson, AR, USA
| | - Z Liu
- Division of Bioinformatics and Biostatistics, National Center for Toxicological Research, U.S. Food and Drug Administration (NCTR/FDA), Jefferson, AR, USA
- Integrative Toxicology, Nonclinical Drug Safety, Boehringer Ingelheim Pharmaceuticals, Inc, Ridgefield, CT, USA
| | - Y Igarashi
- Artificial Intelligence Center for Health and Biomedical Research, National Institutes of Biomedical Innovation, Health and Nutrition (NIBIOHN), Osaka, Japan
| | - H Yamada
- Artificial Intelligence Center for Health and Biomedical Research, National Institutes of Biomedical Innovation, Health and Nutrition (NIBIOHN), Osaka, Japan
| | - K-I Sugiyama
- Division of Genetics and Mutagenesis (DGM), National Institute of Health Sciences (NIHS), Kawasaki, Japan
| | - M Honma
- Division of Genetics and Mutagenesis (DGM), National Institute of Health Sciences (NIHS), Kawasaki, Japan
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8
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Arenas M, Piqué B, Torres-Royo L, Acosta JC, Rodríguez-Tomàs E, De Febrer G, Vasco C, Araguas P, Gómez JA, Malave B, Árquez M, Algara M, Montero A, Montero M, Simó JM, Gabaldó X, Parada D, Riu F, Sabater S, Camps J, Joven J. Treatment of COVID-19 pneumonia with low-dose radiotherapy plus standard of care versus standard of care alone in frail patients : The SEOR-GICOR IPACOVID comparative cohort trial. Strahlenther Onkol 2023; 199:847-856. [PMID: 37000224 PMCID: PMC10064634 DOI: 10.1007/s00066-023-02067-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 02/19/2023] [Indexed: 04/01/2023]
Abstract
PURPOSE To assess the efficacy of lung low-dose radiotherapy (LD-RT) in the treatment of patients with COVID-19 pneumonia. MATERIALS AND METHODS Ambispective study with two cohorts to compare treatment with standard of care (SoC) plus a single dose of 0.5 Gy to the whole thorax (experimental prospective cohort) with SoC alone (control retrospective cohort) for patients with COVID-19 pneumonia not candidates for admission to the intensive care unit (ICU) for mechanical ventilation. RESULTS Fifty patients treated with LD-RT were compared with 50 matched controls. Mean age was 85 years in both groups. An increase in arterial oxygen partial pressure (PaO2)/fraction of inspired oxygen (PAFI) in the experimental LD-RT-treated group compared to the control group could not be found at 48 h after LD-RT, which was the primary endpoint of the study. However, PAFI values significantly improved after 1 month (473 vs. 302 mm Hg; p < 0.0001). Pulse oxymetric saturation/fraction of inspired oxygen (SAFI) values were also significantly higher in LD-RT-treated patients than in control patients at 1 week (405 vs. 334 mm Hg; p = 0.0157) and 1 month after LD-RT (462 vs. 326 mm Hg; p < 0.0001). All other timepoint measurements of the respiratory parameters were similar across groups. Patients in the experimental group were discharged from the hospital significantly earlier (23 vs. 31 days; p = 0.047). Fifteen and 26 patients died due to COVID-19 pneumonia in the experimental and control cohorts, respectively (30% vs. 48%; p = 0.1). LD-RT was associated with a decreased odds ratio (OR) for 1‑month COVID-19 mortality (OR = 0.302 [0.106-0.859]; p = 0.025) when adjusted for potentially confounding factors. Overall survival was significantly prolonged in the LD-RT group compared to the control group (log-rank p = 0.027). No adverse events related to radiation treatment were observed. CONCLUSION Treatment of frail patients with COVID-19 pneumonia with SoC plus single-dose LD-RT of 0.5 Gy improved respiratory parameters, reduced the period of hospitalization, decreased the rate of 1‑month mortality, and prolonged actuarial overall survival compared to SoC alone.
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Affiliation(s)
- M. Arenas
- Department of Radiation Oncology, Hospital Universitari Sant Joan de Reus, Universitat Rovira i Virgili, Tarragona, Spain
- Institut d’Investigacions Pere Virgili, Tarragona, Spain
| | - B. Piqué
- Department of Pathology, Hospital Universitari Sant Joan de Reus, Tarragona, Spain
| | - L. Torres-Royo
- Department of Radiation Oncology, Hospital Universitari Sant Joan de Reus, Universitat Rovira i Virgili, Tarragona, Spain
- Institut d’Investigacions Pere Virgili, Tarragona, Spain
| | - J. C. Acosta
- Department of Radiation Oncology, Hospital Universitari Sant Joan de Reus, Universitat Rovira i Virgili, Tarragona, Spain
- Institut d’Investigacions Pere Virgili, Tarragona, Spain
| | - E. Rodríguez-Tomàs
- Department of Radiation Oncology, Hospital Universitari Sant Joan de Reus, Universitat Rovira i Virgili, Tarragona, Spain
- Unitat de Recerca Biomèdica, Universitat Rovira i Virgili, Tarragona, Spain
- Institut d’Investigacions Pere Virgili, Tarragona, Spain
| | - G. De Febrer
- Department of Geriatric and Palliative care, Hospital Universitari Sant Joan de Reus, Tarragona, Spain
| | - C. Vasco
- Department of Geriatric and Palliative care, Hospital Universitari Sant Joan de Reus, Tarragona, Spain
| | - P. Araguas
- Department of Radiation Oncology, Hospital Universitari Sant Joan de Reus, Universitat Rovira i Virgili, Tarragona, Spain
- Institut d’Investigacions Pere Virgili, Tarragona, Spain
| | - J. A. Gómez
- Department of Radiation Oncology, Hospital Universitari Sant Joan de Reus, Universitat Rovira i Virgili, Tarragona, Spain
- Institut d’Investigacions Pere Virgili, Tarragona, Spain
| | - B. Malave
- Department of Radiation Oncology, Hospital Universitari Sant Joan de Reus, Universitat Rovira i Virgili, Tarragona, Spain
- Institut d’Investigacions Pere Virgili, Tarragona, Spain
| | - M. Árquez
- Department of Radiation Oncology, Hospital Universitari Sant Joan de Reus, Universitat Rovira i Virgili, Tarragona, Spain
- Institut d’Investigacions Pere Virgili, Tarragona, Spain
| | - M. Algara
- Department of Radiation Oncology, Hospital del Mar, Barcelona, Spain
- Autonomous University of Barcelona, Barcelona, Spain
- Institut d’Investigacions Mèdiques, Barcelona, Spain
| | - A. Montero
- Department of Radiation Oncology, HM Hospitales, Madrid, Spain
| | - M. Montero
- Department of Radiology, Hospital Universitari Sant Joan de Reus, Tarragona, Spain
| | - J. M. Simó
- Laboratori de Referència Sud, Hospital Universitari de Sant Joan, Tarragona, Spain
| | - X. Gabaldó
- Laboratori de Referència Sud, Hospital Universitari de Sant Joan, Tarragona, Spain
| | - D. Parada
- Department of Pathology, Hospital Universitari Sant Joan de Reus, Tarragona, Spain
| | - F. Riu
- Department of Pathology, Hospital Universitari Sant Joan de Reus, Tarragona, Spain
| | - S. Sabater
- Department of Radiation Oncology, Complejo Hospitalario de Albacete, Albacete, Spain
| | - J. Camps
- Unitat de Recerca Biomèdica, Universitat Rovira i Virgili, Tarragona, Spain
- Institut d’Investigacions Pere Virgili, Tarragona, Spain
| | - J. Joven
- Unitat de Recerca Biomèdica, Universitat Rovira i Virgili, Tarragona, Spain
- Institut d’Investigacions Pere Virgili, Tarragona, Spain
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9
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Montero A, Ciérvide R, Cañadillas C, Álvarez B, García-Aranda M, Alonso R, López M, Chen-Zhao X, Alonso L, Valero J, Sánchez E, Hernando O, García de Acilu P, Fernandez-Letón P, Rubio C. Acute skin toxicity of ultra-hypofractionated whole breast radiotherapy with simultaneous integrated boost for early breast cancer. Clin Transl Radiat Oncol 2023; 41:100651. [PMID: 37388711 PMCID: PMC10300060 DOI: 10.1016/j.ctro.2023.100651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 05/18/2023] [Accepted: 06/04/2023] [Indexed: 07/01/2023] Open
Abstract
Background Whole-breast irradiation (WBI) after breast conserving surgery (BCS) is indicated to improve loco-regional control and survival. Former studies showed that addition of tumor bed boost in all age groups significantly improved local control although no apparent impact on overall survival but with an increased risk of worse cosmetic outcome. Even though shortened regimens in 3 weeks are considered the standard, recent studies have shown the non-inferiority of a treatment regimen of 5 fractions in one-week in both locoregional control and toxicity profile, although simultaneous integrated boost (SIB) in this setting has been scarcely studied. Materials and Methods From March-2020 to March-2022, 383 patients with early breast cancer diagnosis and a median age of 56 years-old (range 30-99)were included in a prospective registry of ultra-hypofractionated WBI up to a total dose of 26 Gy in 5.2 Gy/fraction with a SIB of 29 Gy in 5.8 Gy/fraction in 272 patients (71%), 30-31 Gy in 6-6.2 Gy/fraction in 111 patients (29%) with close/focally affected margins. Radiation treatment was delivered by conformal 3-D technique in 366 patients (95%), VMAT in 16patients (4%) and conformal 3-D with deep inspiration breath hold (DIBH) in 4patients (1%). Ninety-three per cent of patients received endocrine therapy and 43% systemic or targeted chemotherapy. Development of acute skin complications was retrospectively reviewed. Results With a median follow-up of 18 months (range 7-31), all patients are alive without evidence of local, regional or distant relapse. Acute tolerance was acceptable, with null o mild toxicity: 182 (48%) and 15 (4%) patients developed skin toxicity grade 1 and 2 respectively; 9 (2%) and 2 (0.5%) patients breast edema grade 1and 2 respectively. No other acute toxicities were observed. We also evaluated development of early delayed complications and observed grade 1 breast edema in 6 patients (2%); grade 1 hyperpigmentation in 20 patients (5%); and grade 1 and 2 breast induration underneath boost region in 10(3%) and 2 patients (0.5%) respectively. We found a statistically significant correlation between the median PTVWBI and presence of skin toxicity (p = 0.028) as well as a significant correlation between late hyperpigmentation with the median PTVBOOST (p = 0.007) and the ratio PTVBOOST/PTVWBI (p = 0.042). Conclusion Ultra-hypofractionated WBI + SIB in 5 fractions over one-week is feasible and well tolerated, although longer follow-up is necessary to confirm these results.
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Affiliation(s)
- Angel Montero
- Department of Radiation Oncology, HM Hospitales, Madrid, Spain
- Facultad de Ciencias de la Salud, Universidad Camilo José Cela, Madrid, Spain
| | - Raquel Ciérvide
- Department of Radiation Oncology, HM Hospitales, Madrid, Spain
| | | | - Beatriz Álvarez
- Department of Radiation Oncology, HM Hospitales, Madrid, Spain
| | | | - Rosa Alonso
- Department of Radiation Oncology, HM Hospitales, Madrid, Spain
| | - Mercedes López
- Department of Radiation Oncology, HM Hospitales, Madrid, Spain
| | - Xin Chen-Zhao
- Department of Radiation Oncology, HM Hospitales, Madrid, Spain
| | - Leyre Alonso
- Department of Medical Physics, HM Hospitales, Madrid, Spain
| | - Jeannete Valero
- Department of Radiation Oncology, HM Hospitales, Madrid, Spain
| | - Emilio Sánchez
- Department of Radiation Oncology, HM Hospitales, Madrid, Spain
| | - Ovidio Hernando
- Department of Radiation Oncology, HM Hospitales, Madrid, Spain
| | | | | | - Carmen Rubio
- Department of Medical Physics, HM Hospitales, Madrid, Spain
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10
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Montero A, Alvarez B. The 5Rs dilemma of radiotherapy for non-malignant diseases: 5Rs to darken OR 5Rs to shine. Rep Pract Oncol Radiother 2023; 28:74-78. [PMID: 37122917 PMCID: PMC10132200 DOI: 10.5603/rpor.a2023.0001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 12/15/2022] [Indexed: 05/02/2023] Open
Abstract
Many benign diseases, so called because they are not a direct cause of death, nevertheless cause significant damage to the health of patients due to the associated pain, reduced functionality, increased disability and the negative impact they have on quality of life, which, together with the limited efficacy of many of the available treatments, make their management a challenge for every specialist. Radiotherapy, which has demonstrated its efficacy not only against cancer but also in many non-tumorous diseases, appears as a therapeutic option that deserves to be taken into account. However, there is still much resistance to considering the use of radiotherapy as a valid and acceptable alternative. The 5Rs to darken summarize the doubts and contradictions many specialists face to accept radiotherapy in non-neoplastic diseases. However, other 5Rs (to shine) can be argued to claim for the safety, reliability, and usefulness of radiation treatment for benign disease and as radiotherapy specialists we have to help the evidence shine and the darkness disappear.
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Affiliation(s)
- Angel Montero
- Department of Radiation Oncology, HM Hospitales, Madrid, Spain
- Faculty of Health Sciences, Universidad Camilo José Cela, Madrid, Spain
| | - Beatriz Alvarez
- Department of Radiation Oncology, HM Hospitales, Madrid, Spain
- Faculty of Health Sciences, Universidad Camilo José Cela, Madrid, Spain
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11
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Martin Jimenez M, Lim E, Chavez Mac Gregor M, Bardia A, Wu J, Zhang Q, Nowecki Z, Cruz F, Safin R, Kim SB, Schem C, Montero A, Khan S, Bandyopadhyay R, Shivhare M, Patre M, Martinalbo J, Roncoroni L, Pérez-Moreno P, Sohn J. 211MO Giredestrant (GDC-9545) vs physician choice of endocrine monotherapy (PCET) in patients (pts) with ER+, HER2– locally advanced/metastatic breast cancer (LA/mBC): Primary analysis of the phase II, randomised, open-label acelERA BC study. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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12
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Aristei C, Bölükbaşı Y, Kaidar-Person O, Pfeffer R, Arenas M, Boersma LJ, Ciabattoni A, Coles CE, Franco P, Krengli M, Leonardi MC, Marazzi F, Masiello V, Meattini I, Montero A, Offersen B, Trigo ML, Bourgier C, Genovesi D, Kouloulias V, Morganti AG, Meduri B, Pasinetti N, Pedretti S, Perrucci E, Rivera S, Tombolini V, Vidali C, Valentini V, Poortmans P. Ways to improve breast cancer patients' management and clinical outcome: The 2020 Assisi Think Tank Meeting. Crit Rev Oncol Hematol 2022; 177:103774. [PMID: 35917884 DOI: 10.1016/j.critrevonc.2022.103774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 07/19/2022] [Accepted: 07/29/2022] [Indexed: 10/16/2022] Open
Abstract
We report on the third Assisi Think Tank Meeting (ATTM) on breast cancer, a brainstorming project which involved European radiation and clinical oncologists who were dedicated to breast cancer research and treatment. Held on February 2020, the ATTM aimed at identifying key clinical questions in current clinical practice and "grey" areas requiring research to improve management and outcomes. Before the meeting, three key topics were selected: 1) managing patients with frailty due to either age and/or multi-morbidity; 2) stereotactic radiation therapy and systemic therapy in the management of oligometastatic disease; 3) contralateral breast tumour prevention in BCRA-mutated patients. Clinical practice in these areas was investigated by means of an online questionnaire. In the lapse period between the survey and the meeting, the working groups reviewed data, on-going studies and the clinical challenges which were then discussed in-depth and subjected to intense brainstorming during the meeting; research protocols were also proposed. Methodology, outcome of discussions, conclusions and study proposals are summarized in the present paper. In conclusion, this report presents an in-depth analysis of the state of the art, grey areas and controversies in breast cancer radiation therapy and discusses how to confront them in the absence of evidence-based data to guide clinical decision-making.
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Affiliation(s)
- Cynthia Aristei
- Radiation Oncology Section, Department of Medicine and Surgery, University of Perugia and Perugia General Hospital, Perugia, Italy.
| | - Yasemin Bölükbaşı
- Radiation Oncology Acıbadem Mehmet Ali Aydınlar University School of Medicine, Istanbul, Turkey
| | - Orit Kaidar-Person
- Breast Radiation Unit, Radiation Oncology, Sheba Medical Center, Ramat Gan, Israel
| | - Raphael Pfeffer
- Oncology Institute, Assuta Medical Center, Tel Aviv and Ben Gurion University Medical School, Israel
| | - Meritxell Arenas
- Universitat Rovira I Virgili, Radiation Oncology Department, Hospital Universitari Sant Hoan de Reus, IISPV, Spain
| | - Liesbeth J Boersma
- Radiation Oncology (Maastro), GROW School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Antonella Ciabattoni
- Department of Radiation Oncology, San Filippo Neri Hospital, ASL Rome 1, Rome, Italy
| | | | - Pierfrancesco Franco
- Depatment of Translational Medicine, University of Eastern Piedmont and Department of Radiation Oncology, 'Maggiore della Carità' University Hospital, Novara, Italy
| | - Marco Krengli
- Depatment of Translational Medicine, University of Eastern Piedmont and Department of Radiation Oncology, 'Maggiore della Carità' University Hospital, Novara, Italy
| | | | - Fabio Marazzi
- Unità Operativa di Radioterapia Oncologica, Dipartimento di Diagnostica per Immagine, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Gemelli IRCSS Roma, Italy
| | - Valeria Masiello
- Unità Operativa di Radioterapia Oncologica, Dipartimento di Diagnostica per Immagine, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Gemelli IRCSS Roma, Italy
| | - Icro Meattini
- Department of Experimental and Clinical Biomedical Sciences "M. Serio", University of Florence & Radiation Oncology Unit - Oncology Department, Azienda Ospedaliero Universitaria Careggi, Florence, Italy
| | - Angel Montero
- Department of Radiation Oncology, University Hospital HM Sanchinarro, HM Hospitales, Madrid, Spain
| | - Birgitte Offersen
- Department of Experimental Clinical Oncology, Department of Oncology, Danish Centre for Particle Therapy, Aarhus University Hospital, Aarhus, Denmark
| | - Maria Lurdes Trigo
- Service of Brachytherapy, Department of Image and Radioncology, Instituto Português Oncologia Porto Francisco Gentil E.P.E., Portugal
| | - Céline Bourgier
- Radiation Oncology, ICM-Val d'Aurelle, Univ Montpellier, Montpellier, France
| | - Domenico Genovesi
- Radiation Oncology, Ospedale Clinicizzato Chieti and University "G. d'Annunzio", Chieti, Italy
| | - Vassilis Kouloulias
- 2(nd) Department of Radiology, Radiotherapy Unit, Medical School, National and Kapodistrian University of Athens, Greece
| | - Alessio G Morganti
- Radiation Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna; DIMES, Alma Mater Studiorum Bologna University; Bologna, Italy
| | - Bruno Meduri
- Radiation Oncology Unit, University Hospital of Modena, Modena, Italy
| | - Nadia Pasinetti
- Radiation Oncology Service, ASST Valcamonica Esine and Brescia University, Brescia, Italy
| | - Sara Pedretti
- Istituto del Radio "O.Alberti" - Spedali Civili Hospital and Brescia University, Brescia
| | | | - Sofia Rivera
- Radiation Oncology, Institut Gustave Roussy, Villejuif, France
| | - Vincenzo Tombolini
- Radiation Oncology, Department of Radiological, Oncological and Pathological Science, University "La Sapienza", Roma, Italy
| | - Cristiana Vidali
- former Senior Assistant Department of Radiation Oncology, Azienda Sanitaria Universitaria Integrata di Trieste, Trieste, Italy
| | - Vincenzo Valentini
- Division of Radiation Oncology, IEO European Institute of Oncology, IRCCS, Milan, Italy
| | - Philip Poortmans
- Department of Radiation Oncology, Iridium Kankernetwerk, Antwerp, Belgium; University of Antwerp, Faculty of Medicine and Health Sciences, Antwerp, Belgium
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Acosta Arteaga J, Torres Royo L, Rodríguez-Tomàs E, De Febrer G, Vasco C, Gomez J, Araguas P, Malave B, Arquez M, Algara M, Montero A, Montero M, Simo J, Gavaldà X, Pique B, Parada D, Sabater S, Camps J, Joven J, Arenas M. PO-1450 Clinical Outcome and Radiologic Changes in SARS-CoV-2 Pneumonia treated with Low-Dose Radiotherapy. Radiother Oncol 2022. [PMCID: PMC9153878 DOI: 10.1016/s0167-8140(22)03414-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
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14
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Montero A, Hernando O, Chen-Zhao X, Valero J, Prado A, Sanchez E, Lopez M, Ciervide R, Garcia-Aranda M, Alvarez B, de la Casa M, Alonso R, Fernandez-Leton P, Rubio C. PD-0576 Ultra-hypofractionated SBRT following radical prostatectomy: first results of a phase II trial. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)02891-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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15
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Meattini I, Becherini C, Boersma L, Kaidar-Person O, Marta GN, Montero A, Offersen BV, Aznar MC, Belka C, Brunt AM, Dicuonzo S, Franco P, Krause M, MacKenzie M, Marinko T, Marrazzo L, Ratosa I, Scholten A, Senkus E, Stobart H, Poortmans P, Coles CE. European Society for Radiotherapy and Oncology Advisory Committee in Radiation Oncology Practice consensus recommendations on patient selection and dose and fractionation for external beam radiotherapy in early breast cancer. Lancet Oncol 2022; 23:e21-e31. [PMID: 34973228 DOI: 10.1016/s1470-2045(21)00539-8] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 09/08/2021] [Accepted: 09/08/2021] [Indexed: 12/17/2022]
Abstract
High-quality randomised clinical trials testing moderately fractionated breast radiotherapy have clearly shown that local control and survival is at least as effective as with 2 Gy daily fractions with similar or reduced normal tissue toxicity. Fewer treatment visits are welcomed by patients and their families, and reduced fractions produce substantial savings for health-care systems. Implementation of hypofractionation, however, has moved at a slow pace. The oncology community have now reached an inflection point created by new evidence from the FAST-Forward five-fraction randomised trial and catalysed by the need for the global radiation oncology community to unite during the COVID-19 pandemic and rapidly rethink hypofractionation implementation. The aim of this paper is to support equity of access for all patients to receive evidence-based breast external beam radiotherapy and to facilitate the translation of new evidence into routine daily practice. The results from this European Society for Radiotherapy and Oncology Advisory Committee in Radiation Oncology Practice consensus state that moderately hypofractionated radiotherapy can be offered to any patient for whole breast, chest wall (with or without reconstruction), and nodal volumes. Ultrafractionation (five fractions) can also be offered for non-nodal breast or chest wall (without reconstruction) radiotherapy either as standard of care or within a randomised trial or prospective cohort. The consensus is timely; not only is it a pragmatic framework for radiation oncologists, but it provides a measured proposal for the path forward to influence policy makers and empower patients to ensure equity of access to evidence-based radiotherapy.
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Affiliation(s)
- Icro Meattini
- Department of Experimental and Clinical Biomedical Sciences M Serio, University of Florence, Florence, Italy; Radiation Oncology Unit, Oncology Department, Azienda Ospedaliero Universitaria Careggi, Florence, Italy.
| | - Carlotta Becherini
- Department of Experimental and Clinical Biomedical Sciences M Serio, University of Florence, Florence, Italy; Radiation Oncology Unit, Oncology Department, Azienda Ospedaliero Universitaria Careggi, Florence, Italy
| | - Liesbeth Boersma
- Department of Radiation Oncology (Maastro), GROW School for Oncology and Developmental Biology, Maastricht University Medical Centre+, Maastricht, Netherlands
| | - Orit Kaidar-Person
- Department of Radiation Oncology (Maastro), GROW School for Oncology and Developmental Biology, Maastricht University Medical Centre+, Maastricht, Netherlands; Sheba Medical Center, Ramat Gan and Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Gustavo Nader Marta
- Department of Radiation Oncology-Hospital Sírio-Libanês, São Paulo, Brazil; Latin American Cooperative Oncology Group, Porto Alegre, Brazil
| | - Angel Montero
- Department of Radiation Oncology, HM Hospitales, Madrid, Spain
| | - Birgitte Vrou Offersen
- Department of Experimental Clinical Oncology, Department of Oncology, Danish Centre for Particle Therapy, Aarhus University Hospital, Aarhus, Denmark
| | - Marianne C Aznar
- Division of Cancer Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK; The Christie NHS Foundation Trust, Manchester, UK
| | - Claus Belka
- Department of Radiation Oncology, LMU Klinikum, Ludwig-Maximilians University Munich, Munich, Germany
| | - Adrian Murray Brunt
- School of Medicine, University of Keele, Keele, UK; Clinical Trials and Statistics Unit, The Institute of Cancer Research, London, UK
| | - Samantha Dicuonzo
- Division of Radiation Oncology, IEO, European Institute of Oncology, IRCCS, Milan, Italy
| | - Pierfrancesco Franco
- Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy; Department of Radiation Oncology, Maggiore della Carità University Hospital, Novara, Italy
| | - Mechthild Krause
- Department of Radiation Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany; OncoRay-National Center for Radiation Research in Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden and Helmholtz-Zentrum Dresden-Rossendorf, Dresden, Germany; National Center for Tumor Diseases, Partner Site Dresden, German Cancer Research Center, Heidelberg, Germany; German Cancer Research Center, Heidelberg and German Cancer Consortium, Dresden, Germany; Helmholtz-Zentrum Dresden-Rossendorf, Institute of Radiooncology, Dresden, Germany
| | | | - Tanja Marinko
- Division of Radiation Oncology, Institute of Oncology Ljubljana, Ljubljana, Slovenia; Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Livia Marrazzo
- Medical Physics Unit, Azienda Ospedaliero Universitaria Careggi, Florence, Italy
| | - Ivica Ratosa
- Division of Radiation Oncology, Institute of Oncology Ljubljana, Ljubljana, Slovenia; Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Astrid Scholten
- Department of Radiotherapy, Antoni van Leeuwenhoek-Netherlands Cancer Institute, Amsterdam, Netherlands
| | - Elżbieta Senkus
- Department of Oncology and Radiotherapy, Medical University of Gdańsk, Gdańsk, Poland
| | | | - Philip Poortmans
- Department of Radiation Oncology, Iridium Netwerk, Antwerp, Belgium; University of Antwerp, Faculty of Medicine and Health Sciences, Antwerp, Belgium
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Aramburu F, Montero A, Cabrera Alarcón JL, García de la Peña-Lefevre P. Radiotherapy treatment in benign osteoarticular disease. Reumatol Clin (Engl Ed) 2021; 17:624-625. [PMID: 34823831 DOI: 10.1016/j.reumae.2020.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Accepted: 03/15/2020] [Indexed: 06/13/2023]
Affiliation(s)
- Francisco Aramburu
- Servicio de Reumatología, Hospital Universitario HM Sanchinarro, Madrid, Spain.
| | - Angel Montero
- Servicio de Radioterapia, Hospital Universitario HM Sanchinarro, Madrid, Spain
| | - José Luis Cabrera Alarcón
- Bioinformatic Unit, Genoxphos Research Group, Centro Nacional de Investigaciones Cardiovasculares, Madrid, Spain
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Álvarez B, Montero A, Alonso R, Valero J, López M, Ciérvide R, Sánchez E, Hernando O, García-Aranda M, Martí J, Prado A, Chen-Zhao X, Rubio C. Low-dose radiation therapy for hand osteoarthritis: shaking hands again? Clin Transl Oncol 2021; 24:532-539. [PMID: 34585316 DOI: 10.1007/s12094-021-02710-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 09/13/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Hand osteoarthritis (HOA) is one of the most common causes of pain and functional disability in western countries and there is still no definitive cure. Low-dose radiation therapy (LDRT) has anti-inflammatory properties that have shown to be effective in the symptomatic relief of various degenerative musculoskeletal disorders. We designed a clinical protocol using LDRT for symptomatic HOA and present results and tolerance in the first 100 patients included. MATERIALS AND METHODS Between April 2015 and March 2021, 100 patients with a median age of 60 were treated. Fifty-seven patients suffering from proximal/distal interphalangeal joint pain, 40 patients with thumb arthritis, 2 patients with radiocarpal joint affection and 1 patient with metacarpophalangeal joint pain were enrolled. LDRT comprised of 6 fractions of 0.5-1 Gy on every other day up to a total dose of 3-6 Gy. Clinical response was evaluated according to the visual analog scale (VAS) for pain level and the von Pannewitz score (VPS) for joint functionality. Any patients not achieving subjective adequate pain relief after 8 weeks of treatment were offered a second identical LDRT course. RESULTS With a median follow-up of 10.5 months (range 7.55-12.45), 94% reported an improvement in the pain, with a significant reduction in the VAS level after 3, 6 and 12 months (p < 0.001). Sixty-three patients needed a second course of treatment at a median time interval of 12 weeks (range 9-14). The mean VAS score before treatment was 8 (range 3-10). After treatment, it was 5 (range 1-10). After 3, 6 and 12 months, the mean VAS scores were 4 (range 0-9), 3 (range 0-9) and 3.5 (range 0-9), respectively. Seventy patients reported functionality improvements after LDRT according to the von Pannewitz score. No acute or late complications were observed. CONCLUSION LDRT appears to be safe and useful for HOA and is associated with good rates of pain relief and functionality improvements. However, further studies are necessary to confirm these promising results.
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Affiliation(s)
- B Álvarez
- Department of Radiation Oncology, HM Hospitales, Calle Oña 10, 28050, Madrid, Spain
| | - A Montero
- Department of Radiation Oncology, HM Hospitales, Calle Oña 10, 28050, Madrid, Spain.
| | - R Alonso
- Department of Radiation Oncology, HM Hospitales, Calle Oña 10, 28050, Madrid, Spain
| | - J Valero
- Department of Radiation Oncology, HM Hospitales, Calle Oña 10, 28050, Madrid, Spain
| | - M López
- Department of Radiation Oncology, HM Hospitales, Calle Oña 10, 28050, Madrid, Spain
| | - R Ciérvide
- Department of Radiation Oncology, HM Hospitales, Calle Oña 10, 28050, Madrid, Spain
| | - E Sánchez
- Department of Radiation Oncology, HM Hospitales, Calle Oña 10, 28050, Madrid, Spain
| | - O Hernando
- Department of Radiation Oncology, HM Hospitales, Calle Oña 10, 28050, Madrid, Spain
| | - M García-Aranda
- Department of Radiation Oncology, HM Hospitales, Calle Oña 10, 28050, Madrid, Spain
| | - J Martí
- Department of Medical Physics, HM Hospitales, Madrid, Spain
| | - A Prado
- Department of Medical Physics, HM Hospitales, Madrid, Spain
| | - X Chen-Zhao
- Department of Radiation Oncology, HM Hospitales, Calle Oña 10, 28050, Madrid, Spain
| | - C Rubio
- Department of Radiation Oncology, HM Hospitales, Calle Oña 10, 28050, Madrid, Spain
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Rocque G, Blum J, Montero A, Sonnier S, McCune S, Gallagher C, Pluard T, Cappelleri J, Drucker M, Wang Y, Tripathy D. 315P Treatment patterns in black and indigenous people and people of color (BIPOC) receiving palbociclib for hormone receptor-positive (HR+)/human epidermal growth factor receptor 2-negative (HER2-) advanced breast cancer (ABC) in a real-world setting: POLARIS study results. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Herrero M, Ciérvide R, Calle-Purón ME, Valero J, Buelga P, Rodriguez-Bertos I, Benassi L, Montero A. Macrometastasis at selective lymph node biopsy: A practical going-for-the-one clinical scoring system to personalize decision making. World J Clin Oncol 2021; 12:675-687. [PMID: 34513601 PMCID: PMC8394159 DOI: 10.5306/wjco.v12.i8.675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 05/05/2021] [Accepted: 07/09/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Axillary sentinel lymph node biopsy (SLNB) is standard treatment for patients with clinically and pathological negative lymph nodes. However, the role of completion axillary lymph node dissection (cALND) following positive sentinel lymph node biopsy (SLNB) is debated.
AIM To identify a subgroup of women with high axillary tumor burden undergoing SLNB in whom cALND can be safely omitted in order to reduce the risk of long-term complications and create a Preoperative Clinical Risk Index (PCRI) that helps us in our clinical practice to optimize the selection of these patients.
METHODS Patients with positive SLNB who underwent a cALND were included in this study. Univariate and multivariate analysis of prognostic and predictive factors were used to create a PCRI for safely omitting cALND.
RESULTS From May 2007 to April 2014, we performed 1140 SLN biopsies, of which 125 were positive for tumor and justified to practice a posterior cALND. Pathologic findings at SLNB were micrometastases (mic) in 29 cases (23.4%) and macrometastasis (MAC) in 95 cases (76.6%). On univariate analysis of the 95 patients with MAC, statistically significant factors included: age, grade, phenotype, histology, lymphovascular invasion, lymph-node tumor size, and number of positive SLN. On multivariate analysis, only lymph-node tumor size (≤ 20 mm) and number of positive SLN (> 1) retained significance. A numerical tool was created giving each of the parameters a value to predict preoperatively which patients would not benefit from cALND. Patients with a PCRI ≤ 15 has low probability (< 10%) of having additional lymph node involvement, a PRCI between 15-17.6 has a probability of 43%, and the probability increases to 69% in patients with a PCRI > 17.6.
CONCLUSION The PCRI seems to be a useful tool to prospectively estimate the risk of nodal involvement after positive SLN and to identify those patients who could omit cALND. Further prospective studies are necessary to validate PCRI clinical generalization.
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Affiliation(s)
- Mercedes Herrero
- Department of Gynecology and Obstetrics, HM Hospitales, Madrid 28050, Spain
| | - Raquel Ciérvide
- Department of Radiation Oncology, HM Hospitales, Madrid 28050, Spain
| | - Maria Elisa Calle-Purón
- Department of Preventive Medicine and Public Health, Complutense University of Madrid, Madrid 28050, Spain
| | - Javier Valero
- Department of Gynecology and Obstetrics, HM Hospitales, Madrid 28050, Spain
| | - Paula Buelga
- Department of Gynecology and Obstetrics, HM Hospitales, Madrid 28050, Spain
| | | | - Leticia Benassi
- Department of Gynecology and Obstetrics, HM Hospitales, Madrid 28050, Spain
| | - Angel Montero
- Department of Radiation Oncology, HM Hospitales, Madrid 28050, Spain
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Montero A, Hernando O, Cañon V, Guevara D, Valero J, Chen-Zhao X, Garcia-Acilu P, Sanchez E, Lopez M, Ciervide R, Garcia-Aranda M, Alvarez B, Prado A, Alonso R, Fernandez-Leton P, Rubio C. Radiation therapy with curative intention in men with de novo metastatic prostate carcinoma: shoot'em all! Rep Pract Oncol Radiother 2021; 26:605-615. [PMID: 34434577 PMCID: PMC8382082 DOI: 10.5603/rpor.a2021.0077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 02/27/2021] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND About 5% of prostate cancer cases are metastatic at diagnoses. Radiotherapy of both primary tumor and secondary lesions can be, in addition to systemic treatments, a radical alternative for selected patients. MATERIALS AND METHODS Patients with de novo prostate carcinoma with bone or lymph node metastases were retrospectively reviewed. All patients received moderate hypofractionated IMRT/VMAT up to 63 Gy in 21 daily fractions of 3 Gy to prostate and metastases with neoadjuvant and concurrent androgen deprivation therapy (ADT). According to known advances some patients also received abiraterone, enzalutamide, or docetaxel. RESULTS Between 2015-2020, we attended 26 prostate cancer patients (median age 69.5 years, range 52-84) with simultaneous oligometastases [mean 2.1 metastases, median 1.5 metastases (range 1-6)]. Eighteen patients (69%) presented lymph node metastases, 4 (15.5%) bone metastases and 4 (15.5%) both lymph node and bone metastases. With a median follow-up of 15.5 months (range 3-65 months), 16 patients (62%) are alive and tumor free while 10 (38%) are alive with tumor. Four patients (17%) developed tumor progression, out of irradiated area in all cases, with a median time to progression of 43.5 months (range 27-56 months). Actuarial progression-free survival (PFS) rates at 12 and 24 months were 94.1% and 84.7%, respectively. No grade > 2 acute or late complications were recorded. CONCLUSIONS Simultaneous directed radical hypofractionated radiation therapy for prostate and metastases is feasible, well tolerated and achieves an acceptable PFS rate. However, further studies with longer follow-up are necessary to definitively address these observations.
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Affiliation(s)
- Angel Montero
- Department of Radiation Oncology, HM Hospitales, Madrid, Spain
| | - Ovidio Hernando
- Department of Radiation Oncology, HM Hospitales, Madrid, Spain
| | - Veronica Cañon
- Department of Radiation Oncology, HM Hospitales, Madrid, Spain
| | - Diana Guevara
- Department of Radiation Oncology, HM Hospitales, Madrid, Spain
| | - Jeannete Valero
- Department of Radiation Oncology, HM Hospitales, Madrid, Spain
| | - Xin Chen-Zhao
- Department of Radiation Oncology, HM Hospitales, Madrid, Spain
| | | | - Emilio Sanchez
- Department of Radiation Oncology, HM Hospitales, Madrid, Spain
| | - Mercedes Lopez
- Department of Radiation Oncology, HM Hospitales, Madrid, Spain
| | - Raquel Ciervide
- Department of Radiation Oncology, HM Hospitales, Madrid, Spain
| | | | - Beatriz Alvarez
- Department of Radiation Oncology, HM Hospitales, Madrid, Spain
| | | | - Rosa Alonso
- Department of Radiation Oncology, HM Hospitales, Madrid, Spain
| | | | - Carmen Rubio
- Department of Radiation Oncology, HM Hospitales, Madrid, Spain
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Montero A, Hernando O, Valero J, Chen-Zhao X, Marti J, Prado A, Sanchez E, Lopez M, Ciervide R, Garcia-Aranda M, Alvarez B, Alonso R, Garcia P, Nuñez M, Palma J, Izquierdo M, Rossi K, Cañadillas C, Fernandez-Leton P, Rubio C. PO-1395 Post-prostatectomy ultra-hypofractionated SBRT: preliminary results of a phase II trial. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07846-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Ciervide R, Montero A, Garcia-Aranda M, Alvarez B, Prado A, Chen-Zhaoi X, Alonso R, Lopez M, Hernando O, Sanchez E, Valero J, Nuñez M, Izquierdo M, Rossi K, Cañadillas C, Marti J, Zucca D, Alonso L, Fernandez-Leton P, Rubio C. PO-1143 One-week ultrahypofractionated RT for whole breast and simultaneous integrated boost in DCIS. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07594-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Alvarez B, Montero A, Hernando O, Ciervide R, Garcia J, Lopez M, Garcia-Aranda M, Chen X, Flores I, Sanchez E, Valero J, Prado A, Alonso R, Alonso L, Fernandez-Leton P, Rubio C. Radiotherapy CT-based contouring atlas for non-malignant skeletal and soft tissue disorders: a practical proposal from Spanish experience. Br J Radiol 2021; 94:20200809. [PMID: 34282948 PMCID: PMC8764913 DOI: 10.1259/bjr.20200809] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 05/26/2021] [Accepted: 06/08/2021] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVE Interest in low-dose radiotherapy (LD-RT) for the symptomatic treatment of nonmalignant conditions, including inflammatory and degenerative disorders of the joints and para-articular soft tissues, has increased substantially in recent years. In the present document, we provide a CT-based contouring atlas to help identify and delineate the most common osteoarticular regions susceptible to LD-RT. METHODS The clinical efficacy of LD-RT is supported by a large body of evidence. However, there is no consensus on the parameters for contouring the planning target volume (PTV). Moreover, 3D simulation and planning should be the standard of care even for nonmalignant disorders. For this reason, the present guidelines were prepared to help guide PTV contouring based on CT images, with the same quality criteria for patient immobilization, treatment simulation, planning and delivery as those routinely applied for cancer radiotherapy. RESULTS PTV for radiotherapy requires precise identification of the target areas based on CT and other imaging techniques. Using a series of cases treated at our institution, we have defined the PTVs for each location on the simulation CT to establish the relationship between the image and the anatomical structures to be treated. We also specify the immobilization systems used to ensure treatment accuracy and reproducibility. CONCLUSIONS This comprehensive atlas based on CT images may be of value to radiation oncologists who wish to use LD-RT for the symptomatic treatment of degenerative or inflammatory osteoarticular diseases. ADVANCES IN KNOWLEDGE The recommendations and contouring atlas described in this article provide an eminently practical tool for LD-RT in non-malignant conditions, based on the same quality criteria recommended for all modern radiotherapy treatments in Spain.
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Affiliation(s)
- Beatriz Alvarez
- Department of Radiation Oncology, HM Hospitales, Madrid, Spain
| | - Angel Montero
- Department of Radiation Oncology, HM Hospitales, Madrid, Spain
| | - Ovidio Hernando
- Department of Radiation Oncology, HM Hospitales, Madrid, Spain
| | - Raquel Ciervide
- Department of Radiation Oncology, HM Hospitales, Madrid, Spain
| | - Juan Garcia
- Department of Medical Physics, HM Hospitales, Madrid, Spain
| | - Mercedes Lopez
- Department of Radiation Oncology, HM Hospitales, Madrid, Spain
| | | | - Xin Chen
- Department of Radiation Oncology, HM Hospitales, Madrid, Spain
| | - Ines Flores
- Department of Medical Physics, HM Hospitales, Madrid, Spain
| | - Emilio Sanchez
- Department of Radiation Oncology, HM Hospitales, Madrid, Spain
| | | | | | - Rosa Alonso
- Department of Radiation Oncology, HM Hospitales, Madrid, Spain
| | - Leyre Alonso
- Department of Radiation Oncology, HM Hospitales, Madrid, Spain
| | | | - Carmen Rubio
- Department of Radiation Oncology, HM Hospitales, Madrid, Spain
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López González M, Ciervide R, Hernando O, Sanchez E, Montero A, Garcia-Aranda M, Alvarez B, Chen-Zhao X, Alonso R, Valero J, Fernandez-Leton P, Rubio C. PO-1049 Hypofractionated stereotactic reirradiation in patients with high-grade gliomas. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07500-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Ciervide R, Montero A, García-Aranda M, Alvarez B, Chen-Zhaoi X, Alonso R, Lopez M, Hernando O, Sanchez E, Valero J, Nuñez M, Izquierdo M, Rossi K, Cañadillas C, De la Casa M, Marti J, Alonso L, Fernandez Leton P, Rubio C. PH-0223 Pathological complete response after preoperative chemoradiotherapy for HER2+/TN breast cancer. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07275-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Rubio Rodríguez M, Arias F, Chen-Zhao X, Flamarique S, Fernández-Letón P, Campo M, López M, Rodríguez M, Zucca D, Martínez D, Sánchez-Saugar E, Mañeru F, García Ruiz-Zorrilla J, García de Acilu P, Valero J, Montero A, Ciérvide R, Alvarez B, García-Aranda M, Alonso R, de la Casa M, Alonso L, Nuñez M, Martí J, Hernando O. OC-0416 Results of SBRT-SG-01, a prospective multicentric-study of SBRT for liver metastases. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)06903-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Hernando-Requejo O, Lopez M, Chen X, Alonso R, Sanchez E, Montero A, Ciervide R, Alvarez B, Valero J, Garcia M, Zucca D, Garcia J, Garcia de Azilu P, Alonso L, De la Casa M, Prado A, Marti J, Fernandez Leton P, Nuñez M, Izquierdo M, Rossi K, Cañadillas C, Rubio C. PO-1240 Complete pathological response after high dose radiotherapy for locally advanced esophageal cancer. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07691-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Arenas M, Algara M, De Febrer G, Rubio C, Sanz X, de la Casa MA, Vasco C, Marín J, Fernández-Letón P, Villar J, Torres-Royo L, Villares P, Membrive I, Acosta J, López-Cano M, Araguas P, Quera J, Rodríguez-Tomás F, Montero A. Could pulmonary low-dose radiation therapy be an alternative treatment for patients with COVID-19 pneumonia? Preliminary results of a multicenter SEOR-GICOR nonrandomized prospective trial (IPACOVID trial). Strahlenther Onkol 2021; 197:1010-1020. [PMID: 34230996 PMCID: PMC8260020 DOI: 10.1007/s00066-021-01803-3] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 06/01/2021] [Indexed: 02/08/2023]
Abstract
Purpose To evaluate the efficacy and safety of lung low-dose radiation therapy (LD-RT) for pneumonia in patients with coronavirus disease 2019 (COVID-19). Materials and methods Inclusion criteria comprised patients with COVID-19-related moderate–severe pneumonia warranting hospitalization with supplemental O2 and not candidates for admission to the intensive care unit because of comorbidities or general status. All patients received single lung dose of 0.5 Gy. Respiratory and systemic inflammatory parameters were evaluated before irradiation, at 24 h and 1 week after LD-RT. Primary endpoint was increased in the ratio of arterial oxygen partial pressure (PaO2) or the pulse oximetry saturation (SpO2) to fractional inspired oxygen (FiO2) ratio of at least 20% at 24 h with respect to the preirradiation value. Results Between June and November 2020, 36 patients with COVID-19 pneumonia and a mean age of 84 years were enrolled. Seventeen were women and 19 were men and all of them had comorbidities. All patients had bilateral pulmonary infiltrates on chest X‑ray. All patients received dexamethasone treatment. Mean SpO2 pretreatment value was 94.28% and the SpO2/FiO2 ratio varied from 255 mm Hg to 283 mm Hg at 24 h and to 381 mm Hg at 1 week, respectively. In those who survived (23/36, 64%), a significant improvement was observed in the percentage of lung involvement in the CT scan at 1 week after LD-RT. No adverse effects related to radiation treatment have been reported. Conclusions LD-RT appears to be a feasible and safe option in a population with COVID-19 bilateral interstitial pneumonia in the presence of significant comorbidities. Supplementary Information The online version of this article (10.1007/s00066-021-01803-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- M. Arenas
- Universitat Rovira i Virgili, Tarragona, Spain
- Institut d’Investigacions Pere Virgili, Tarragona, Spain
- Department of Radiation Oncology, Hospital Universitari Sant Joan de Reus, Tarragona, Spain
| | - M. Algara
- Department of Radiation Oncology, Hospital del Mar, Barcelona, Spain
- Autonomous University of Barcelona, Barcelona, Spain
- Institut Hospital del Mar d’Investigacions Mèdiques, Barcelona, Spain
| | - G. De Febrer
- Universitat Rovira i Virgili, Tarragona, Spain
- Department of Geriatric and Palliative care, Hospital Universitari Sant Joan de Reus, Tarragona, Spain
| | - C. Rubio
- Department of Radiation Oncology, HM Hospitales., Madrid, Spain
| | - X. Sanz
- Department of Radiation Oncology, Hospital del Mar, Barcelona, Spain
- Institut Hospital del Mar d’Investigacions Mèdiques, Barcelona, Spain
- Pompeu Fabra University Barcelona, Barcelona, Spain
| | | | - C. Vasco
- Universitat Rovira i Virgili, Tarragona, Spain
- Department of Geriatric and Palliative care, Hospital Universitari Sant Joan de Reus, Tarragona, Spain
| | - J. Marín
- Institut Hospital del Mar d’Investigacions Mèdiques, Barcelona, Spain
- Department of Critical Care, Hospital del Mar, Barcelona, Spain
| | | | - J. Villar
- Institut Hospital del Mar d’Investigacions Mèdiques, Barcelona, Spain
- Department of Infection Diseases, Hospital del Mar, Barcelona, Spain
| | - L. Torres-Royo
- Universitat Rovira i Virgili, Tarragona, Spain
- Institut d’Investigacions Pere Virgili, Tarragona, Spain
- Department of Radiation Oncology, Hospital Universitari Sant Joan de Reus, Tarragona, Spain
| | - P. Villares
- Department of Internal Medicine, HM Hospitales, Madrid, Spain
| | - I. Membrive
- Department of Radiation Oncology, Hospital del Mar, Barcelona, Spain
- Autonomous University of Barcelona, Barcelona, Spain
| | - J. Acosta
- Universitat Rovira i Virgili, Tarragona, Spain
- Institut d’Investigacions Pere Virgili, Tarragona, Spain
- Department of Radiation Oncology, Hospital Universitari Sant Joan de Reus, Tarragona, Spain
| | - M. López-Cano
- Department of Internal Medicine, HM Hospitales, Madrid, Spain
| | - P. Araguas
- Universitat Rovira i Virgili, Tarragona, Spain
- Institut d’Investigacions Pere Virgili, Tarragona, Spain
- Department of Radiation Oncology, Hospital Universitari Sant Joan de Reus, Tarragona, Spain
| | - J. Quera
- Department of Radiation Oncology, Hospital del Mar, Barcelona, Spain
- Institut Hospital del Mar d’Investigacions Mèdiques, Barcelona, Spain
- Pompeu Fabra University Barcelona, Barcelona, Spain
| | - F. Rodríguez-Tomás
- Universitat Rovira i Virgili, Tarragona, Spain
- Institut d’Investigacions Pere Virgili, Tarragona, Spain
- Department of Radiation Oncology, Hospital Universitari Sant Joan de Reus, Tarragona, Spain
| | - A. Montero
- Department of Radiation Oncology, HM Hospitales., Madrid, Spain
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Valero J, Montero A, Hernando O, Izquierdo M, Sánchez E, García-Aranda M, López M, Ciérvide R, Martí J, Álvarez B, Alonso R, Chen-Zhao X, Fernández-Letón P, Rubio C. Moderate hypofractionated post-prostatectomy radiation therapy is feasible and well tolerated: experience from a single tertiary cancer centre. Clin Transl Oncol 2021; 23:1452-1462. [PMID: 33433839 DOI: 10.1007/s12094-020-02543-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 12/14/2020] [Indexed: 12/24/2022]
Abstract
PURPOSE Conventional post-prostatectomy radiation therapy comprises 6.5-8 weeks of treatment, therefore, hypofractionated and shortened schemes arouse increasing interest. We describe our experience regarding feasibility and clinical outcome of a post-prostatectomy moderate hypofractionated image-guided radiotherapy schedule MATERIALS AND METHODS: From Oct 2015-Mar 2020, 113 patients, median age of 62 years-old (range 45-76) and prostate adenocarcinoma of low risk (30%), intermediate risk (49%) and high risk (21%) were included for adjuvant (34%) or salvage radiation therapy (66%) after radical prostatectomy (RP). All patients underwent radiotherapy with image-guided IMRT/VMAT to a total dose of 62.5 Gy in 2.5 Gy/fraction in 25 fractions. Sixteen patients (14%) received concomitant androgen deprivation therapy. RESULTS With a median follow-up of 29 months (range 3-60 months) all patients but three are alive. Eleven patients (10%) developed exclusive biochemical relapse while 19 patients (17%) presented macroscopically visible relapse: prostatectomy bed in two patients (2%), pelvic lymph nodes in 13 patients (11.5%) and distant metastases in four patients (4%). The 3 years actuarial rates for OS, bFRS, and DMFS were 99.1, 91.1 and 91.2%, respectively. Acute and late tolerance was satisfactory. Maximal acute genitourinary (AGU) toxicity was G2 in 8% of patients; maximal acute gastrointestinal (AGI) toxicity was G2 in 3.5% of patients; maximal late genitourinary (LGU) toxicity was G3 in 1% of patients and maximal late gastrointestinal (LGI) toxicity was G2 in 2% of patients. There were no cases of severe acute or late toxicity. No relationship was found between acute or late GI/GU adverse effects and dosimetric parameters, age, presence of comorbidities or concomitant treatments. CONCLUSIONS Hypofractionated radiotherapy (62.5 Gy in 25 2.5 Gy fractions) is feasible and well tolerated with low complication rates allowing for a moderate dose-escalation that offers encouraging clinical results for biochemical control and survival in patients with prostate cancer after radical prostatectomy.
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Affiliation(s)
- J Valero
- Department of Radiation Oncology, Hospital Universitario HM Sanchinarro, HM Hospitales, c/Oña 10, 28050, Madrid, Spain
| | - A Montero
- Department of Radiation Oncology, Hospital Universitario HM Sanchinarro, HM Hospitales, c/Oña 10, 28050, Madrid, Spain.
| | - O Hernando
- Department of Radiation Oncology, Hospital Universitario HM Sanchinarro, HM Hospitales, c/Oña 10, 28050, Madrid, Spain
| | - M Izquierdo
- Department of Radiation Oncology, Hospital Universitario HM Sanchinarro, HM Hospitales, c/Oña 10, 28050, Madrid, Spain
| | - E Sánchez
- Department of Radiation Oncology, Hospital Universitario HM Sanchinarro, HM Hospitales, c/Oña 10, 28050, Madrid, Spain
| | - M García-Aranda
- Department of Radiation Oncology, Hospital Universitario HM Sanchinarro, HM Hospitales, c/Oña 10, 28050, Madrid, Spain
| | - M López
- Department of Radiation Oncology, Hospital Universitario HM Sanchinarro, HM Hospitales, c/Oña 10, 28050, Madrid, Spain
| | - R Ciérvide
- Department of Radiation Oncology, Hospital Universitario HM Sanchinarro, HM Hospitales, c/Oña 10, 28050, Madrid, Spain
| | - J Martí
- Department of Medical Physics, HM Hospitales, Madrid, Spain
| | - B Álvarez
- Department of Radiation Oncology, Hospital Universitario HM Sanchinarro, HM Hospitales, c/Oña 10, 28050, Madrid, Spain
| | - R Alonso
- Department of Radiation Oncology, Hospital Universitario HM Sanchinarro, HM Hospitales, c/Oña 10, 28050, Madrid, Spain
| | - X Chen-Zhao
- Department of Radiation Oncology, Hospital Universitario HM Sanchinarro, HM Hospitales, c/Oña 10, 28050, Madrid, Spain
| | | | - C Rubio
- Department of Radiation Oncology, Hospital Universitario HM Sanchinarro, HM Hospitales, c/Oña 10, 28050, Madrid, Spain
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Nuñez Baez M, Montero A, Chen-Zhao X, Acosta A, Alvarez B, Palma J, Lopez-Gonzalez M, Sanchez E, Hernando O, Valero J, Ciervide R, Garcia-Aranda M, Alonso R, De la Casa M, Zucca D, Martí J, Flores-Cacho I, Ruiz-Morales C, Fernandez-Leton P, Rubio Rodriguez M. PO-1233: Perioperative Radiotherapy with a Moderate Dose-Escalation for Retroperitoneal Sarcoma (RPS). Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)01251-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Algara M, Arenas M, Marin J, Vallverdu I, Fernandez-Letón P, Villar J, Fabrer G, Rubio C, Montero A. Low dose anti-inflammatory radiotherapy for the treatment of pneumonia by covid-19: A proposal for a multi-centric prospective trial. Clin Transl Radiat Oncol 2020; 24:29-33. [PMID: 32613089 PMCID: PMC7317159 DOI: 10.1016/j.ctro.2020.06.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 06/06/2020] [Accepted: 06/12/2020] [Indexed: 01/20/2023] Open
Abstract
Interstitial bilateral pneumonia is the main complication of severe COVID-19. Low-dose radiation therapy (LD-RT) has well-known anti-inflammatory effects. LD-RT can interfere with the hyper-inflammatory cascade associated with severe COVID-19. LD-RT could reduce the severity of associated cytokine release caused by COVID-19. This trial will evaluate efficacy of lung LD-RT for interstitial COVID-19 pneumonia.
Background COVID-19 is a highly contagious viral infection with high morbidity that is draining health resources. The biggest complication is pneumonia, which has a serious inflammatory component, with no standardized treatment. Low-dose radiation therapy (LD-RT) is non-invasive and has anti-inflammatory effects that can interfere with the inflammatory cascade, thus reducing the severity of associated cytokine release and might be useful in the treatment of respiratory complications caused by COVID-19. Study design and methods This multicentric prospective clinical trial seeks to evaluate the efficacy of bilateral lung LD-RT therapy as a treatment for interstitial pneumonia in patients with COVID-19 for improving respiratory function. This prospective study will have 2 phases: I) an exploratory phase enrolling 10 patients, which will assess the feasibility and efficacy of low-dose lung irradiation, evaluated according to an increase in the PaO2/FiO2 ratio of at least 20% at 48–72 h with respect to the pre-irradiation value. If a minimum efficiency of 30% of the patients is not achieved, the study will not be continued. II) Non-randomized comparative phase in two groups: a control group, which will only receive pharmacological treatment, and an experimental arm with pharmacological treatment and LD-RT. It will include 96 patients, the allocation will be 1: 2, that is, 32 in the control arm and 64 in the experimental arm. The primary end-point will be the efficacy of LD-RT in patients with COVID-19 pneumonia according to an improvement in PaO2/FiO2. Secondary objectives will include the safety of bilateral lung LD-RT, an improvement in the radiology image, overall mortality rates at 15 and 30 days after irradiation and characterizing anti-inflammatory mechanisms of LD-RT by measuring the level of expression of adhesion molecules, anti-inflammatory cytokines and oxidative stress mediators. Trial registration: ClinicalTrial.gov NCT-04380818 https://clinicaltrials.gov/ct2/show/NCT04380818?term=RADIOTHERAPY&cond=COVID&draw=2&rank=4.
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Affiliation(s)
- M. Algara
- Department of Radiation Oncology, Hospital del Mar, Autonomous University of Barcelona, Spain
| | - M. Arenas
- Department of Radiation Oncology, University Hospital Sant Joan de Reus, Rovira iV irgili University, Tarragona, Spain
| | - J. Marin
- Intensive Care Unit, Hospital del Mar, Barcelona, Spain
| | - I. Vallverdu
- Intensive Care Unit University Hospital Sant Joan de Reus, Universitat Rovira I Virgili, Tarragona, Spain
| | - P. Fernandez-Letón
- Department of Radiation Physics, University Hospital HM Sanchinarro, Madrid, Spain
| | - J. Villar
- Department of Infectious Diseases, Hospital del Mar, Barcelona, Spain
| | - G. Fabrer
- Department of Geriatric and Palliative Care, University Hospital Sant Joan de Reus, Rovira i Virgili University, Tarragona, Spain
| | - C. Rubio
- Department of Radiation Oncology, University Hospital HM Sanchinarro, Madrid, Spain
| | - A. Montero
- Department of Radiation Oncology, University Hospital HM Sanchinarro, Madrid, Spain
- Corresponding author.
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Montero A, Nuñez M, Hernando O, Vicente E, Ciervide R, Zucca D, Sanchez E, López M, Quijano Y, Garcia-Aranda M, Alonso R, Valero J, Chen X, Alvarez B, Fernandez-Leton P, Rubio C. Retroperitoneal soft-tissue sarcomas: Radiotherapy experience from a tertiary cancer center and review of current evidence. Rep Pract Oncol Radiother 2020; 25:643-655. [PMID: 32565743 DOI: 10.1016/j.rpor.2020.05.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 04/14/2020] [Accepted: 05/25/2020] [Indexed: 12/19/2022] Open
Abstract
Background Surgery remains to be the main therapeutic approach for retroperitoneal sarcomas (RPS) although evidence supports that complementary radiotherapy increases local-control and survival. We present a multidisciplinary management and experience of a tertiary cancer center in the treatment of RPS and analyze current evidence of radiotherapy efficacy. Patients and methods We retrospectively reviewed 19 patients with primary or relapsed RPS treated between November 2009 and October 2018. Multidisciplinary approach comprised complete resection in 15 patients (79%) achieving resection R0 in 11 patients (58%), R1 in 4 patients (21%) and R2 in 2 patients (10%). Seven patients (37%) underwent a preoperative radiation (PRORT), 10 patients (53%), post-operative radiation (PORT) and 2 patients (10%), received radiotherapy exclusively. Ten patients (53%) received adjuvant chemotherapy. Results With a median follow-up of 24 months (2-114 months), actuarial rates of loco-regional relapse free survival (LRFS) at 1, 2 and 3 years were 77%, 77% and 67%, respectively. Actuarial rates of distant-metastases-free survival (DMFS), disease-free survival (DFS) and overall survival (OS) at 1, 2 and 3 years were 100%, 100% and 80% for DMFS; 94%, 77% and 67% for DFS and 100%, 91% and 91% for OS, respectively. Only surgical margins (negative vs. positive) showed significance for 3y-LRFS: 100% vs. 34.3%, p = 0.018. Treatment tolerance was acceptable with no acute or late toxicity higher than grade 2. Conclusions Complementary radiotherapy appears to be useful and well tolerated for the multidisciplinary management of RPS. Presence of positive surgical margins seems to be the most relevant prognostic factor through the follow-up.
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Affiliation(s)
- A Montero
- Department of Radiation Oncology, University Hospital HM Sanchinarro, Madrid, Spain
| | - M Nuñez
- Department of Radiation Oncology, University Hospital HM Sanchinarro, Madrid, Spain
| | - O Hernando
- Department of Radiation Oncology, University Hospital HM Sanchinarro, Madrid, Spain
| | - E Vicente
- Department of General Surgery, University Hospital HM Sanchinarro, Madrid, Spain
| | - R Ciervide
- Department of Radiation Oncology, University Hospital HM Sanchinarro, Madrid, Spain
| | - D Zucca
- Department of Medical Physics, University Hospital HM Sanchinarro, Madrid, Spain
| | - E Sanchez
- Department of Radiation Oncology, University Hospital HM Sanchinarro, Madrid, Spain
| | - M López
- Department of Radiation Oncology, University Hospital HM Sanchinarro, Madrid, Spain
| | - Y Quijano
- Department of General Surgery, University Hospital HM Sanchinarro, Madrid, Spain
| | - M Garcia-Aranda
- Department of Radiation Oncology, University Hospital HM Sanchinarro, Madrid, Spain
| | - R Alonso
- Department of Radiation Oncology, University Hospital HM Sanchinarro, Madrid, Spain
| | - J Valero
- Department of Radiation Oncology, University Hospital HM Sanchinarro, Madrid, Spain
| | - X Chen
- Department of Radiation Oncology, University Hospital HM Sanchinarro, Madrid, Spain
| | - B Alvarez
- Department of Radiation Oncology, University Hospital HM Sanchinarro, Madrid, Spain
| | - P Fernandez-Leton
- Department of Medical Physics, University Hospital HM Sanchinarro, Madrid, Spain
| | - C Rubio
- Department of Radiation Oncology, University Hospital HM Sanchinarro, Madrid, Spain
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Aramburu F, Montero A, Cabrera Alarcón JL, García de la Peña-Lefevre P. Radiotherapy Treatment in Benign Osteoarticular Disease. Reumatol Clin (Engl Ed) 2020; 17:S1699-258X(20)30072-3. [PMID: 32487479 DOI: 10.1016/j.reuma.2020.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 02/17/2020] [Accepted: 03/15/2020] [Indexed: 01/15/2023]
Affiliation(s)
- Francisco Aramburu
- Servicio de Reumatología, Hospital Universitario HM Sanchinarro, Madrid, España.
| | - Angel Montero
- Servicio de Radioterapia, Hospital Universitario HM Sanchinarro, Madrid, España
| | - José Luis Cabrera Alarcón
- Bioinformatic Unit. Genoxphos Research Group, Centro Nacional de Investigaciones Cardiovasculares, Madrid, España
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Montero A, Arenas M, Algara M. Low-dose radiation therapy: could it be a game-changer for COVID-19? Clin Transl Oncol 2020; 23:1-4. [PMID: 32451973 PMCID: PMC7247741 DOI: 10.1007/s12094-020-02401-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Accepted: 05/12/2020] [Indexed: 12/02/2022]
Affiliation(s)
- A Montero
- Oncología Radioterápica, Hospital Universitario HM Sanchinarro, Madrid, Spain.
| | - M Arenas
- Oncología Radioterápica, Hospital Universitario Sant Joan de Reus, Universitat Rovira I Virgili, Reus, Spain
| | - M Algara
- Oncología Radioterápica, Hospital de la Esperanza, Parc de Salut del Mar, Universitat Autónoma de Barcelona, Barcelona, Spain
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Montero A, Ciérvide R, García-Aranda M, Rubio C. Postmastectomy radiation therapy in early breast cancer: Utility or futility? Crit Rev Oncol Hematol 2020; 147:102887. [PMID: 32018127 DOI: 10.1016/j.critrevonc.2020.102887] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 01/08/2020] [Accepted: 01/27/2020] [Indexed: 01/31/2023] Open
Abstract
Postmastectomy radiation therapy (PMRT) has been shown to reduce the risk of locoregional recurrence (LRR), in patients with locally advanced breast cancer who are considered of high-risk because of large tumors (>5 cm) or presence of axillary lymph-node involvement, as well as to reduce breast cancer mortality. However, controversy still remains with respect to indication of PMRT in case of early-stages invasive tumors. This review aims to analyze the impact that PMRT has on final results in women with breast tumors in different scenarios that would otherwise be considered as early breast cancer, such as extensive DCIS, tumors without axillary lymph-node involvement or with minimal microscopic nodal-involvement. The existence of risk factors including young age, premenopausal status, and presence of lymphovascular invasion (LVI), high grade or tumor size >2 cm has been associated with an increased risk of LRR in these patients at early-stages and advises to consider PMRT in selected cases.
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Affiliation(s)
- Angel Montero
- Department of Radiation Oncology, Hospital Universitario HM Sanchinarro, Centro Integral Oncológico Clara Campal (CIOCC), Madrid, Spain; Breast Cancer Unit, Hospital Universitario HM Sanchinarro, Madrid, Spain.
| | - Raquel Ciérvide
- Department of Radiation Oncology, Hospital Universitario HM Sanchinarro, Centro Integral Oncológico Clara Campal (CIOCC), Madrid, Spain; Breast Cancer Unit, Hospital Universitario HM Sanchinarro, Madrid, Spain
| | - Mariola García-Aranda
- Department of Radiation Oncology, Hospital Universitario HM Sanchinarro, Centro Integral Oncológico Clara Campal (CIOCC), Madrid, Spain; Breast Cancer Unit, Hospital Universitario HM Sanchinarro, Madrid, Spain
| | - Carmen Rubio
- Department of Radiation Oncology, Hospital Universitario HM Sanchinarro, Centro Integral Oncológico Clara Campal (CIOCC), Madrid, Spain; Breast Cancer Unit, Hospital Universitario HM Sanchinarro, Madrid, Spain
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Chen-Zhao X, Hernando O, López M, Sánchez E, Montero A, García-Aranda M, Ciérvide R, Valero J, Alonso R, Cárdenas-Rebollo JM, Vicente E, Quijano Y, Cubillo A, Álvarez R, Prados S, Plaza C, García J, Zucca D, Fernández-Letón P, Rubio C. A prospective observational study of the clinical and pathological impact of stereotactic body radiotherapy (SBRT) as a neoadjuvant strategy of chemoradiation in pancreatic cancer. Clin Transl Oncol 2020; 22:1499-1505. [PMID: 31974820 DOI: 10.1007/s12094-020-02287-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2019] [Accepted: 01/01/2020] [Indexed: 01/30/2023]
Abstract
PURPOSE/OBJECTIVE(S) To improve the curative resection rates and prognoses, a variety of neoadjuvant (NA) strategies have been explored in PDAC. In our institution, non-metastatic PDACs have been treated with a NA intent with induction multiagent chemotherapy and SBRT. The primary endpoint was to increase R0 resection rate. The secondary endpoints were the analysis of the clinical tolerance, the pathological response, the local control (LC) and the OS. MATERIALS/METHODS All consecutive patients with non-metastatic PDAC underwent SBRT as part of the NA strategy were included. A total dose of 40-62 Gy were delivered in 5-10 fractions. Surgery was performed after SBRT and restaging. RESULTS Since February 2014 to December 2018, 45 patients were enrolled. Thirty-two patients underwent surgery (71.1%), 10 out of 15 were initially unresectable disease patients (66.75%). R0 resection rate was 93% (30 patients) and pN0 status was achieved in 20 patients (60.6%). Tumour regression grade (TRG): 12 patients with complete response or marked response (TRG 0-1: 37.5%), 16 patients with moderate response (TRG 2: 50%) and four patients with poor response (TRG 3: 12.5%). The median follow-up was 16.2 m (range 6.6-59.6 m) since diagnosis. The LC rate achieved was very high (95.5%). Actuarial 12 and 24 m OS was 67.4% and 35.9% respectively. No grade 3 or higher toxicity related to SBRT was observed. CONCLUSION The results are encouraging, suggesting that SBRT has a significant role in the management of these patients and further studies will be necessary to prove these findings.
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Affiliation(s)
- X Chen-Zhao
- Radiation Oncology, University Hospital HM Sanchinarro-Puerta del Sur, Madrid, Spain.
| | - O Hernando
- Radiation Oncology, University Hospital HM Sanchinarro-Puerta del Sur, Madrid, Spain
| | - M López
- Radiation Oncology, University Hospital HM Sanchinarro-Puerta del Sur, Madrid, Spain
| | - E Sánchez
- Radiation Oncology, University Hospital HM Sanchinarro-Puerta del Sur, Madrid, Spain
| | - A Montero
- Radiation Oncology, University Hospital HM Sanchinarro-Puerta del Sur, Madrid, Spain
| | - M García-Aranda
- Radiation Oncology, University Hospital HM Sanchinarro-Puerta del Sur, Madrid, Spain
| | - R Ciérvide
- Radiation Oncology, University Hospital HM Sanchinarro-Puerta del Sur, Madrid, Spain
| | - J Valero
- Radiation Oncology, University Hospital HM Sanchinarro-Puerta del Sur, Madrid, Spain
| | - R Alonso
- Radiation Oncology, University Hospital HM Sanchinarro-Puerta del Sur, Madrid, Spain
| | - J M Cárdenas-Rebollo
- Department of Applied Mathematics and Statistics, CEU San Pablo University, Madrid, Spain
| | - E Vicente
- General and Gastrointestinal Surgery, University Hospital HM Sanchinarro, Madrid, Spain
| | - Y Quijano
- General and Gastrointestinal Surgery, University Hospital HM Sanchinarro, Madrid, Spain
| | - A Cubillo
- Medical Oncology, University Hospital HM Sanchinarro, Madrid, Spain
| | - R Álvarez
- Medical Oncology, University Hospital HM Sanchinarro, Madrid, Spain
| | - S Prados
- Gastroenterology, University Hospital HM Sanchinarro, Madrid, Spain
| | - C Plaza
- Anatomical Pathology, University Hospital HM Sanchinarro, Madrid, Spain
| | - J García
- Medical Physics, University Hospital HM Sanchinarro-Puerta del Sur, Madrid, Spain
| | - D Zucca
- Medical Physics, University Hospital HM Sanchinarro-Puerta del Sur, Madrid, Spain
| | - P Fernández-Letón
- Medical Physics, University Hospital HM Sanchinarro-Puerta del Sur, Madrid, Spain
| | - C Rubio
- Radiation Oncology, University Hospital HM Sanchinarro-Puerta del Sur, Madrid, Spain
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Rubio C, Chen X, Lopez M, Hernando O, Sanchez E, Montero A, Aranda MG, Ciervide R, Valero J, Alonso R, Vicente E, Quijano Y, Cubillo A, Gallego RA, Prados S, Plaza C, Pérez J, Garcia J, Zucca D, Leton PF. A Prospective Observational Study of the Impact of Stereotactic Body Radiotherapy (SBRT) As a Neoadjuvant Strategy of Chemoradiation in Pancreatic Cancer. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.1925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Bonvalot S, Rutkowski PL, Thariat J, Carrère S, Ducassou A, Sunyach MP, Agoston P, Hong A, Mervoyer A, Rastrelli M, Moreno V, Li RK, Tiangco B, Herraez AC, Gronchi A, Mangel L, Sy-Ortin T, Hohenberger P, de Baère T, Le Cesne A, Helfre S, Saada-Bouzid E, Borkowska A, Anghel R, Co A, Gebhart M, Kantor G, Montero A, Loong HH, Vergés R, Lapeire L, Dema S, Kacso G, Austen L, Moureau-Zabotto L, Servois V, Wardelmann E, Terrier P, Lazar AJ, Bovée JVMG, Le Péchoux C, Papai Z. NBTXR3, a first-in-class radioenhancer hafnium oxide nanoparticle, plus radiotherapy versus radiotherapy alone in patients with locally advanced soft-tissue sarcoma (Act.In.Sarc): a multicentre, phase 2-3, randomised, controlled trial. Lancet Oncol 2019; 20:1148-1159. [PMID: 31296491 DOI: 10.1016/s1470-2045(19)30326-2] [Citation(s) in RCA: 234] [Impact Index Per Article: 46.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 04/23/2019] [Accepted: 04/26/2019] [Indexed: 12/14/2022]
Abstract
BACKGROUND Pathological complete response to preoperative treatment in adults with soft-tissue sarcoma can be achieved in only a few patients receiving radiotherapy. This phase 2-3 trial evaluated the safety and efficacy of the hafnium oxide (HfO2) nanoparticle NBTXR3 activated by radiotherapy versus radiotherapy alone as a pre-operative treatment in patients with locally advanced soft-tissue sarcoma. METHODS Act.In.Sarc is a phase 2-3 randomised, multicentre, international trial. Adults (aged ≥18 years) with locally advanced soft-tissue sarcoma of the extremity or trunk wall, of any histological grade, and requiring preoperative radiotherapy were included. Patients had to have a WHO performance status of 0-2 and a life expectancy of at least 6 months. Patients were randomly assigned (1:1) by an interactive web response system to receive either NBTXR3 (volume corresponding to 10% of baseline tumour volume at a fixed concentration of 53·3 g/L) as a single intratumoural administration before preoperative external-beam radiotherapy (50 Gy in 25 fractions) or radiotherapy alone, followed by surgery. Randomisation was stratified by histological subtype (myxoid liposarcoma vs others). This was an open-label study. The primary endpoint was the proportion of patients with a pathological complete response, assessed by a central pathology review board following European Organisation for Research and Treatment of Cancer guidelines in the intention-to-treat population full analysis set. Safety analyses were done in all patients who received at least one puncture and injection of NBTXR3 or at least one dose of radiotherapy. This study is registered with ClinicalTrials.gov, number NCT02379845, and is ongoing for long-term follow-up, but recruitment is complete. FINDINGS Between March 3, 2015, and Nov 21, 2017, 180 eligible patients were enrolled and randomly assigned and 179 started treatment: 89 in the NBTXR3 plus radiotherapy group and 90 in the radiotherapy alone group. Two patients in the NBTXR3 group and one patient in the radiotherapy group were excluded from the efficacy analysis because they were subsequently discovered to be ineligible; thus, a total of 176 patients were analysed for the primary endpoint in the intention-to-treat full analysis set (87 in the NBTXR3 group and 89 in the radiotherapy alone group). A pathological complete response was noted in 14 (16%) of 87 patients in the NBTXR3 group and seven (8%) of 89 in the radiotherapy alone group (p=0·044). In both treatment groups, the most common grade 3-4 treatment-emergent adverse event was postoperative wound complication (eight [9%] of 89 patients in the NBTXR3 group and eight [9%] of 90 in the radiotherapy alone group). The most common grade 3-4 adverse events related to NBTXR3 administration were injection site pain (four [4%] of 89) and hypotension (four [4%]) and the most common grade 3-4 radiotherapy-related adverse event was radiation skin injury in both groups (five [6%] of 89 in the NBTXR3 group and four [4%] of 90 in the radiotherapy alone group). The most common treatment-emergent grade 3-4 adverse event related to NBTXR3 was hypotension (six [7%] of 89 patients). Serious adverse events were observed in 35 (39%) of 89 patients in the NBTXR3 group and 27 (30%) of 90 patients in the radiotherapy alone group. No treatment-related deaths occurred. INTERPRETATION This trial validates the mode of action of this new class of radioenhancer, which potentially opens a large field of clinical applications in soft-tissue sarcoma and possibly other cancers. FUNDING Nanobiotix SA.
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Affiliation(s)
- Sylvie Bonvalot
- Department of Surgery, Institut Curie, PSL Research University, Paris, France.
| | - Piotr L Rutkowski
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie Institute-Oncology Center, Institute of Oncology, Warsaw, Poland
| | - Juliette Thariat
- Department of Radiation Oncology, Centre François Baclesse, Caen, France; Department of Radiation Oncology, Centre Lacassagne, Nice, France
| | - Sébastien Carrère
- Department of Surgical Oncology, Centre Regional De Lutte Contre Le Cancer Paul Lamarque, Montpellier, France
| | - Anne Ducassou
- Department of Radiation Oncology, Institut Claudius Regaud (ICR), Institut Universitaire du Cancer de Toulouse-Oncopole (IUCT-O), Toulouse, France
| | | | - Peter Agoston
- Department of Radiation Oncology, Országos Onkologiai Intézet, Budapest, Hungary
| | - Angela Hong
- Department of Radiation Oncology, Chris O'Brien Lifehouse and The University of Sydney, Camperdown, NSW, Australia
| | - Augustin Mervoyer
- Department of Radiation Oncology, Institut de Cancerologie de l'Ouest- Rene Gauducheau, Saint-Herblain, France
| | - Marco Rastrelli
- Department of Surgical Oncology, Istituto Oncologico Veneto IRCCS, Padova, Italy
| | - Victor Moreno
- Department of Medical Oncology, Hospital Fundación Jimenez Diaz, Madrid, Spain
| | - Rubi K Li
- Department of Medical Oncology, St Luke's Medical Center, Quezon City, Philippines
| | - Béatrice Tiangco
- Department of Medical Oncology, The Medical City Cancer Center, Pasay City, Philippines
| | - Antonio Casado Herraez
- Department of Medical Oncology, Hospital Clinico Universitario San Carlos, Madrid, Spain
| | - Alessandro Gronchi
- Department of Surgery, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy
| | - László Mangel
- Department of Oncotherapy, University of Pecs, Pecs, Hungary
| | - Teresa Sy-Ortin
- Department of Radiation Oncology, Benavides Cancer Institute, University of Santo Tomas Hospital, Manila, Philippines
| | - Peter Hohenberger
- Department of Surgery, Division of Surgical Oncology and Thoracic Surgery, University Hospital Mannheim, University of Heidelberg, Mannheim, Germany
| | - Thierry de Baère
- Department of Interventional Radiology, Gustave Roussy-Cancer Campus, Villejuif, France
| | - Axel Le Cesne
- Department of Medical Oncology, Gustave Roussy-Cancer Campus, Villejuif, France
| | - Sylvie Helfre
- Department of Radiation Therapy, Institut Curie, PSL Research University, Paris, France
| | - Esma Saada-Bouzid
- Department of Medical Oncology, Centre Anticancer Antoine Lacassagne, Nice, France
| | - Aneta Borkowska
- Department of Radiotherapy, Maria Sklodowska-Curie Institute-Oncology Center, Institute of Oncology, Warsaw, Poland
| | - Rodica Anghel
- Institutul Oncologic Bucuresti Prof Dr Alexandru Trestioreanu, Bucharest, Romania
| | - Ann Co
- Cebu Cancer Institute, Perpetual Succour Hospital, Cebu City, Philippines
| | - Michael Gebhart
- Department of Orthopedic Surgery, ULB, Institut Jules Bordet, Brussels, Belgium
| | - Guy Kantor
- Department of Radiotherapy, Institut Bergonié, Comprehensive Cancer Center, Bordeaux, France
| | - Angel Montero
- Radiation Oncology Department, Hospital HM Universitario Sanchinarro, Madrid, Spain
| | - Herbert H Loong
- Department of Clinical Oncology, Prince of Wales Hospital, Sha Tin, Hong Kong
| | - Ramona Vergés
- Radiation Oncology Department, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Lore Lapeire
- Department of Medical Oncology, Ghent University Hospital, Gent, Belgium
| | - Sorin Dema
- Municipal Emergency Hospital Timisoara, Timisoara, Romania
| | - Gabriel Kacso
- Iuliu Hatieganu Medical University, RTC Amethyst, Cluj, Romania
| | - Lyn Austen
- Department of Radiation Oncology, Canberra Region Cancer Centre, Garran, Australia
| | | | - Vincent Servois
- Department of Radiology, Institut Curie, PSL Research University, Paris, France
| | - Eva Wardelmann
- Gerhard Domagk Institute of Pathology, University Hospital Münster, Münster, Germany
| | - Philippe Terrier
- Gustave Roussy, Cancer Campus, Paris-Sud University, Villejuif, France
| | - Alexander J Lazar
- Departments of Pathology & Genomic Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Judith V M G Bovée
- Department of Pathology, Leiden University Medical Center, Leiden, Netherlands
| | - Cécile Le Péchoux
- Department of Radiation Oncology, Gustave Roussy-Cancer Campus, Villejuif, France
| | - Zsusanna Papai
- Medical Centre, Hungarian Defence Forces, Budapest, Hungary
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Cambra A, Besga B, Montero A, González-Rivera M, Ruano M. Stability of amino acids and acylcarnitines in dried blood spots stored at room temperature over a one-year period. Clin Chim Acta 2019. [DOI: 10.1016/j.cca.2019.03.1238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Montero A, Sabater S, Rödel F, Gaipl US, Ott OJ, Seegenschmiedt MH, Arenas M. Is it time to redefine the role of low-dose radiotherapy for benign disease? Ann Rheum Dis 2018; 79:e34. [DOI: 10.1136/annrheumdis-2018-214873] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Accepted: 12/08/2018] [Indexed: 01/09/2023]
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Ortiz –Villalón C, De Petris L, Kis L, Yoshikawa A, Ngoc H, Roden A, Fukuoka J, Montero A. P3.09-05 Significance of the Expression of PD-L1/PD-1 by Tumoral and Immune Cells in Non-Small Cell Lung Cancer. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.1774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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De gonzalo calvo D, Dávalos A, Fernández-sanjurjo M, Amado-rodríguez L, Díaz-coto S, Tomás-zapico C, Montero A, García-gonzález A, Llorente-cortés V, Díaz-martínez A, Úbeda N, Iglesias-guitérrez E. Circulating micrornas as emerging cardiac biomarkers: Response to acute exercise and implications for clinical practice. Atherosclerosis 2018. [DOI: 10.1016/j.atherosclerosis.2018.06.789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Montero A, Hernandez M, Ciervide R, Garcia-Aranda M, Alvarez B, Valero J, Acosta A, Alonso R, Lopez M, Sanchez E, Hernando O, Rubio C. Efficacy of an accelerated hypofractionted schedule for whole breast and regional node irradiation: Short term results of safety and efficacy. Eur J Cancer 2018. [DOI: 10.1016/s0959-8049(18)30393-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Acosta Rojas A, Montero A, Valero J, Alvarez B, Hernando O, Sanchez E, Lopez M, Garcia-Aranda M, Ciervide R, Alonso R, Chen X, Rubio C. EP-1595: Comparative analysis of PSA kinetics related to 4 different radiotherapy modalities. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)31904-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Bonet M, Arenas M, Farré N, García V, Algara M, Farrús B, Fernández J, Reyes V, Eraso A, Alvarez A, Cambra M, Pedro A, Vayreda J, Montero A, Poortmans P. EP-1297: RT for bone-only oligometastases in breast cancer patients: a survey of current clinical practice. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)31607-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Hernanz de Lucas R, Montero A, Candini D, Fernandez E, Sancho S. EP-1688: Low-dose radiotherapy in painful degenerative osteoarthritis: long-term efficacy and outcomes. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)31997-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Ciervide R, López M, Hernando O, Sánchez E, Montero A, Valero J, García-Aranda M, Chen X, Alonso R, Alvarez B, Acosta A, Rubio C. EP-1195: Hypofractionated stereotactic radiotherapy (HFSRT) for 50 brain metastases: Institutional experience. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)31505-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Affiliation(s)
- Alejandro de la Torre
- Department of Radiation Oncology, University Hospital “Clínica Puerta de Hierro”, Madrid, Spain
| | - Jesus Romero
- Department of Radiation Oncology, University Hospital “Clínica Puerta de Hierro”, Madrid, Spain
| | - Angel Montero
- Department of Radiation Oncology, University Hospital “Clínica Puerta de Hierro”, Madrid, Spain
| | | | - Francisco J Valcarcel
- Department of Radiation Oncology, University Hospital “Clínica Puerta de Hierro”, Madrid, Spain
| | - Sofia Cordoba
- Department of Radiation Oncology, University Hospital “Clínica Puerta de Hierro”, Madrid, Spain
| | - Rosa Magallon
- Department of Radiation Oncology, University Hospital “Clínica Puerta de Hierro”, Madrid, Spain
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De La Torre A, Romero J, Montero A, Garcia-Berrocal MI, Valcarcel FJ, Cordoba S, Magallon R. Radiochemotherapy with Cisplatin and Oral Tegafur in Advanced Head and Neck Cancer: Long-Term Results of a Phase II Study. Tumori 2018; 94:453-8. [DOI: 10.1177/030089160809400402] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Aims and Background To evaluate the tolerance and efficacy of an original concurrent radiochemotherapy regimen in locally advanced head and neck cancer. Methods Sixty-four patients with stage III or IV squamous cell carcinoma arising from a head and neck mucosal site were eligible. Simultaneous radiochemotherapy consisted of two courses of continuous infusional cisplatin (20 mg/m2/d, days 1–4 and 29–32) and oral tegafur (1200 mg/d, days 1–14 and 29–43), together with conventional radiation therapy up to a total dose of 70–75 Gy over nine weeks. Results All the patients were evaluated for toxicity and response. Acute mucositis was the most prevalent complication. Grade 3 toxicities were mucositis (44%), skin toxicity (10%), leukopenia (8%), and thrombocytopenia (1%). No toxic death was observed. Complete response to treatment was observed in 72% of patients. With a median follow-up of 48.5 months (range, 27–84), 5-year actuarial rate of local-regional control, disease-free survival, overall survival and disease-specific survival were 60% (95% confidence interval [CI], 40–70%), 55% (95% CI, 45–65%), 51% (95% CI, 43–59%) and 61% (95% CI, 53–69%), respectively. Conclusions Response, local-regional control and survival rates are equivalent to those reported from other concomitant radiochemotherapy combinations. However, the regimen offers the advantage of its tolerance and toxicity profile.
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Affiliation(s)
- Alejandro De La Torre
- Department of Radiation Oncology, University Hospital “Clínica Puerta de Hierro”, Madrid, Spain
| | - Jesus Romero
- Department of Radiation Oncology, University Hospital “Clínica Puerta de Hierro”, Madrid, Spain
| | - Angel Montero
- Department of Radiation Oncology, University Hospital “Clínica Puerta de Hierro”, Madrid, Spain
| | | | - Francisco J Valcarcel
- Department of Radiation Oncology, University Hospital “Clínica Puerta de Hierro”, Madrid, Spain
| | - Sofia Cordoba
- Department of Radiation Oncology, University Hospital “Clínica Puerta de Hierro”, Madrid, Spain
| | - Rosa Magallon
- Department of Radiation Oncology, University Hospital “Clínica Puerta de Hierro”, Madrid, Spain
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Izquierdo M, Hernández-García F, Lopez-Parra M, Del Rosario A, Montero A, Pérez M, García-Gudiño J, García-Rubio L, Garrido N. Estudios de caracteres de canal y carne de diferentes genotipos de cerdo Ibérico alimentados en un sistema tradicional extensivo. ARCH ZOOTEC 2018. [DOI: 10.21071/az.v67isupplement.3604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Caracteres de la canal y calidad de carne de tres genotipos distintos de ibérico puro, Retinto (R), Torbiscal (T) y Torbiscal*Retinto (TR), y un cruce de Duroc*Retinto (DR) han sido estudiados. Se han utilizado 48 cerdos, 12 por genotipo. El espesor de los diferentes depósitos de la grasa dorsal: interno (i), medio (m), externo (o) y total (t), medidos a nivel de la décima y decimo cuarta costilla (iBF10, mBF10, oBF10, tBF10, iBF14, mBF14, oBF14 y tBF14, respectivamente) se midieron en la canal así como el área del lomo (LA10 y LA14, respectivamente) y el porcentaje de grasa intramuscular (IMF) se determinó químicamente. Los pesos (W) y rendimientos (Y) de las piezas más importantes: jamón (H), paleta (F), lomo (L), y solomillo (TL) se recogieron (HW, FW, LW, TLW y HY, FY y LY, respectivamente). Los pesos y rendimientos de todas las piezas se calculó también (TCW y TCY). Como el genotipo DR creció más rápido de lo esperado, estos animales se finalizaron con un concentrado y no con bellota como los otros tres genotipos. Así, el genotipo DR solo se compara para caracteres de canal. Los datos se analizaron utilizando el procedimiento GLM de SAS, ajustando por el peso de canal dentro de cada genotipo como covariable. Como resultados el genotipo R tuvo valores de IMF, IBF10, MBF10 y TBF10, significativamente mayores que los otros genotipos y el genotipo T tuvo valores significativamente mayores que los otros genotipos para OBF10 y OBF14. Además, HW y HY obtuvieron valores semejantes para todos los genotipos, pero TR y DT obtuvieron paletas y lomos más pesados que los genotipos R y T. Dentro de los genotipos ibéricos puros TR obtuvo mejores TCW y TCY que R pero igual que T. Por otro lado, el genotipo DR fue el que obtuvo los mejores valores para TCW y TCY.
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