News Update on Radiation Oncology Research: Jan – 2020

Modern Radiation Therapy for Extranodal Lymphomas: Field and Dose Guidelines From the International Lymphoma Radiation Oncology Group

Extranodal lymphomas (ENLs) comprise a few third of all non-Hodgkin lymphomas (NHL). radiotherapy (RT) is usually used as either primary therapy (particularly for indolent ENL), consolidation after systemic therapy, salvage treatment, or palliation. The wide selection of presentations of ENL, involving any organ within the body and therefore the spectrum of histological sub-types, poses a challenge both for routine clinical care and for the conduct of prospective and retrospective studies. This has led to uncertainty and lack of consistency in RT approaches between centers and clinicians. so far there’s a scarcity of guidelines for the utilization of RT within the management of ENL. This report presents an attempt by the International Lymphoma Radiation Oncology Group (ILROG) to harmonize and standardize the principles of treatment of ENL, and to deal with the technical challenges of simulation, volume definition and treatment planning for the foremost frequently involved organs. [1]

Modern Radiation Therapy for Nodal Non-Hodgkin Lymphoma—Target Definition and Dose Guidelines From the International Lymphoma Radiation Oncology Group

Radiation therapy (RT) is that the best single modality for local control of non-Hodgkin lymphoma (NHL) and is a crucial component of therapy for several patients. Many of the historic concepts of dose and volume have recently been challenged by the arrival of recent imaging and RT planning tools. The International Lymphoma Radiation Oncology Group (ILROG) has developed these guidelines after multinational meetings and analysis of obtainable evidence. the rules represent an agreed consensus view of the ILROG committee on the utilization of RT in NHL within the era . The roles of reduced volume and reduced doses are addressed, integrating modern imaging with 3-dimensional planning and advanced techniques of RT delivery. [2]

Tumor microenvironmental physiology and its implications for radiation oncology

The microenvironmental physiology of tumors is uniquely different from that of normal tissues. it’s characterized, inter alia, by O2 depletion (hypoxia, anoxia), glucose and energy deprivation, high lactate levels, and extracellular acidosis, parameters that are anisotropically distributed within the tumor mass. This hostile microenvironment is essentially dictated by the abnormal tumor vasculature and heterogeneous microcirculation. Hypoxia and other hostile microenvironmental parameters are known to directly or indirectly confer resistance to irradiation resulting in treatment failure. Hypoxia directly results in a reduced “fixation” of radiation-induced DNA damage. [3]

Radiation oncology in the era of precision medicine

Technological advances and clinical research over the past few decades have given radiation oncologists the potential to personalize treatments for accurate delivery of radiation dose supported clinical parameters and anatomical information. Eradication of gross and microscopic tumours with preservation of health-related quality of life are often achieved in many patients. Two major strategies, acting synergistically, will enable further widening of the therapeutic window of radiation oncology within the era of precision medicine: technology-driven improvement of treatment conformity, including advanced image guidance and particle therapy, and novel biological concepts for personalized treatment, including biomarker-guided prescription, combined treatment modalities and adaptation of treatment during its course. [4]

Carotid Body Tumour a Challenging Management: Rare Case Report in Baghdad Radiation Oncology Center, Medical City, Baghdad, Iraq

Background: Paragangliomas are rare asymptomatic painless tumours, originating from paraganglionic bodies of autonomous nerve system. The chemoreceptor tumours are the relatively rare tumour but constitute a majority of head and neck paragangliomas about 70%. These tumours are benign but possess aggressive local growth potential.

The Aim of the Study: the aim of this case report article is to introduce the challenging we exposed thereto during management such cases in our country despite lack many conditions, facilities and circumstances found in other parts of the planet for treatment of CBT, which is that the first time and motion study in Iraq. [5]

Reference

[1] Yahalom, J., Illidge, T., Specht, L., Hoppe, R.T., Li, Y.X., Tsang, R., Wirth, A. and Group, I.L.R.O., 2015. Modern radiation therapy for extranodal lymphomas: field and dose guidelines from the International Lymphoma Radiation Oncology Group. International Journal of Radiation Oncology* Biology* Physics, 92(1), (Web Link)

[2] Illidge, T., Specht, L., Yahalom, J., Aleman, B., Berthelsen, A.K., Constine, L., Dabaja, B., Dharmarajan, K., Ng, A., Ricardi, U. and Wirth, A., 2014. Modern radiation therapy for nodal non-Hodgkin lymphoma—target definition and dose guidelines from the International Lymphoma Radiation Oncology Group. International Journal of Radiation Oncology* Biology* Physics, 89(1), (Web Link)

[3] Vaupel, P., 2004, July. Tumor microenvironmental physiology and its implications for radiation oncology. In Seminars in radiation oncology (Vol. 14, No. 3, pp. 198-206). WB Saunders. (Web Link)

[4] Radiation oncology in the era of precision medicine
Michael Baumann, Mechthild Krause, Jens Overgaard, Jürgen Debus, Søren M. Bentzen, Juliane Daartz, Christian Richter, Daniel Zips & Thomas Bortfeld
Nature Reviews Cancer volume 16, (Web Link)

[5] J. Al-Rawaq, K., A. Al-Naqqash, M., S. Al-Shewered, A. and F. Al-Awadi, A. (2018) “Carotid Body Tumour a Challenging Management: Rare Case Report in Baghdad Radiation Oncology Center, Medical City, Baghdad, Iraq”, Journal of Cancer and Tumor International, 7(3), (Web Link)

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