Stereotactic Body Radiotherapy

A special issue of Journal of Personalized Medicine (ISSN 2075-4426). This special issue belongs to the section "Methodology, Drug and Device Discovery".

Deadline for manuscript submissions: closed (10 September 2021) | Viewed by 7390

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Guest Editor
Radiation Oncology Section, Department of Medicine and Surgery, University of Perugia, 06129 Perugia, Italy
Interests: conformal radiation therapy; stereotactic radiotherapy; ablative radiotherapy; intensity modulated radiation therapy; radiobiology; breast cancer; urological tumours; prostate cancer
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Special Issue Information

Dear Colleagues,

Stereotactic radiotherapy (SRT) is a treatment option curing cancer that creates highly conformal dose distributions with steep dose gradients, using advanced planning and treatment equipment. Stereotactic radiotherapy allows for the safe delivery of high doses of radiation to the target lesion, while sparing the surrounding critical organs. More specifically, in clinical practice, it is a useful tool in patients affected by limited metastatic disease, defined as an “oligometastatic state”, which is considered as an intermediate state between localized and widespread cancer. In patients with a limited number of metastases from a variety of primary sites, it seems that SRT might improve overall survival and disease-progression-free survival, with a limited cost in terms of treatment-related morbidity. SRT is also under investigation for the treatment of primary tumors, instead of surgery or conventional radiotherapy, such as for curing lung cancer and prostate cancer. For these reasons, this Special Issue will explore the use of stereotactic radiotherapy in the therapy of solid tumors. Researchers are encouraged to submit their scientific contributions for “Stereotactic Body Radiotherapy”.

Dr. Gianluca Ingrosso
Guest Editor

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Keywords

  • Stereotactic radiotherapy
  • Solid tumors
  • Oligometastases
  • Stereotactic body radiotherapy
  • Stereotactic ablative body radiotherapy

Published Papers (3 papers)

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Research

14 pages, 2052 KiB  
Article
Evaluation of 1β-Hydroxylation of Deoxycholic Acid as a Non-Invasive Urinary Biomarker of CYP3A Activity in the Assessment of Inhibition-Based Drug–Drug Interaction in Healthy Volunteers
by Xue-Qing Li, Roslyn Stella Thelingwani, Leif Bertilsson, Ulf Diczfalusy, Tommy B. Andersson and Collen Masimirembwa
J. Pers. Med. 2021, 11(6), 457; https://0-doi-org.brum.beds.ac.uk/10.3390/jpm11060457 - 24 May 2021
Cited by 2 | Viewed by 2223
Abstract
In this study, we aimed to evaluate the utility of endogenous 1β-hydroxy-deoxycholic acid/total deoxycholic acid ratio (1β-OH-DCA/ToDCA) in spot urine as a surrogate marker of cytochrome P450 3A (CYP3A) activity in the assessment inhibition-based drug–drug interactions in healthy volunteers. This was accomplished through [...] Read more.
In this study, we aimed to evaluate the utility of endogenous 1β-hydroxy-deoxycholic acid/total deoxycholic acid ratio (1β-OH-DCA/ToDCA) in spot urine as a surrogate marker of cytochrome P450 3A (CYP3A) activity in the assessment inhibition-based drug–drug interactions in healthy volunteers. This was accomplished through an open-label, three-treatment parallel-arm study in healthy male volunteers from Zimbabwe. Each group received itraconazole (ITZ; 100 mg once daily; n = 10), fluconazole (FKZ; 50 mg once daily; n = 9), or alprazolam (APZ; 1 mg once daily; n = 8) orally. Midazolam (MDZ), dosed orally and intravenously, was used as a comparator to validate the exploratory measures of CYP3A activity and the effects of known inhibitors. Urinary metabolic ratios of 1β-OH-DCA/ToDCA before and after CYP3A inhibitor treatment showed a similar magnitude of inhibitory effects of the three treatments as that measured by oral MDZ clearance. The maximum inhibition effect of a 75% reduction in the 1β-OH-DCA/ToDCA ratio compared to the baseline was achieved in the ITZ group following six once-daily doses of 100 mg. The correlations of the two markers for CYP3A inhibitor treatment were significant (rs = 0.53, p < 0.01). The half-life of urinary endogenous 1β-OH-DCA/ToDCA was estimated as four days. These results suggested that 1β-OH-DCA/ToDCA in spot urine is a promising convenient, non-invasive, sensitive, and relatively quickly responsive endogenous biomarker that can be used for CYP3A inhibition-based drug–drug interaction in clinical studies. Full article
(This article belongs to the Special Issue Stereotactic Body Radiotherapy)
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12 pages, 248 KiB  
Article
Radiomics Analysis of 3D Dose Distributions to Predict Toxicity of Radiotherapy for Cervical Cancer
by François Lucia, Vincent Bourbonne, Dimitris Visvikis, Omar Miranda, Dorothy M. Gujral, Dominique Gouders, Gurvan Dissaux, Olivier Pradier, Florent Tixier, Vincent Jaouen, Julien Bert, Mathieu Hatt and Ulrike Schick
J. Pers. Med. 2021, 11(5), 398; https://0-doi-org.brum.beds.ac.uk/10.3390/jpm11050398 - 11 May 2021
Cited by 11 | Viewed by 2471
Abstract
Standard treatment for locally advanced cervical cancer (LACC) is chemoradiotherapy followed by brachytherapy. Despite radiation therapy advances, the toxicity rate remains significant. In this study, we compared the prediction of toxicity events after radiotherapy for locally advanced cervical cancer (LACC), based on either [...] Read more.
Standard treatment for locally advanced cervical cancer (LACC) is chemoradiotherapy followed by brachytherapy. Despite radiation therapy advances, the toxicity rate remains significant. In this study, we compared the prediction of toxicity events after radiotherapy for locally advanced cervical cancer (LACC), based on either dose-volume histogram (DVH) parameters or the use of a radiomics approach applied to dose maps at the voxel level. Toxicity scores using the Common Terminology Criteria for Adverse Events (CTCAE v4), spatial dose distributions, and usual clinical predictors for the toxicity of 102 patients treated with chemoradiotherapy followed by brachytherapy for LACC were used in this study. In addition to usual DVH parameters, 91 radiomic features were extracted from rectum, bladder and vaginal 3D dose distributions, after discretization into a fixed bin width of 1 Gy. They were evaluated for predictive modelling of rectal, genitourinary (GU) and vaginal toxicities (grade ≥ 2). Logistic Normal Tissue Complication Probability (NTCP) models were derived using clinical parameters only or combinations of clinical, DVH and radiomics. For rectal acute/late toxicities, the area under the curve (AUC) using clinical parameters was 0.53/0.65, which increased to 0.66/0.63, and 0.76/0.87, with the addition of DVH or radiomics parameters, respectively. For GU acute/late toxicities, the AUC increased from 0.55/0.56 (clinical only) to 0.84/0.90 (+DVH) and 0.83/0.96 (clinical + DVH + radiomics). For vaginal acute/late toxicities, the AUC increased from 0.51/0.57 (clinical only) to 0.58/0.72 (+DVH) and 0.82/0.89 (clinical + DVH + radiomics). The predictive performance of NTCP models based on radiomics features was higher than the commonly used clinical and DVH parameters. Dosimetric radiomics analysis is a promising tool for NTCP modelling in radiotherapy. Full article
(This article belongs to the Special Issue Stereotactic Body Radiotherapy)
9 pages, 245 KiB  
Article
Oligometastatic Prostate Adenocarcinoma. Clinical-Pathologic Study of a Histologically Under-Recognized Prostate Cancer
by Claudia Manini, Alba González, David Büchser, Jorge García-Olaverri, Arantza Urresola, Ana Ezquerro, Iratxe Fernández, Roberto Llarena, Iñaki Zabalza, Rafael Pulido, Arkaitz Carracedo, Alfonso Gómez-Iturriaga and José I. López
J. Pers. Med. 2020, 10(4), 265; https://0-doi-org.brum.beds.ac.uk/10.3390/jpm10040265 - 04 Dec 2020
Cited by 3 | Viewed by 2052
Abstract
The clinical parameters and the histological and immunohistochemical findings of a prospective protocolized series of 27 prostate carcinoma patients with oligometastatic disease followed homogeneously were analyzed. Lymph nodes (81.5%) and bones (18.5%) were the only metastatic sites. Local control after metastatic directed treatment [...] Read more.
The clinical parameters and the histological and immunohistochemical findings of a prospective protocolized series of 27 prostate carcinoma patients with oligometastatic disease followed homogeneously were analyzed. Lymph nodes (81.5%) and bones (18.5%) were the only metastatic sites. Local control after metastatic directed treatment was achieved in 22 (81.5%) patients. A total of 8 (29.6%) patients developed castration-resistant prostate cancer. Seventeen (63%) patients presented with non-organ confined disease. The Gleason index 8–10 was the most frequently observed (12 cases, 44.4%) combined grade. Positive immunostainings were detected with androgen receptor (100%), PGP 9.5 (74%), ERG (40.7%), chromogranin A (29.6%), and synaptophysin (18.5%) antibodies. The Ki-67 index value > 5% was observed in 15% of the cases. L1CAM immunostaining was negative in all cases. Fisher exact test showed that successful local control of metastases was associated to mild inflammation, organ confined disease, Ki-67 index < 5%, and Gleason index 3 + 3. A castration resistant status was associated with severe inflammation, atrophy, a Gleason index higher than 3 + 3, Ki-67 index ≥ 5%, and positive PGP 9.5, chromogranin A, and synaptophysin immunostainings. In conclusion, oligometastatic prostate adenocarcinoma does not have a specific clinical-pathologic profile. However, some histologic and immunohistochemical parameters of routine use may help with making therapeutic decisions. Full article
(This article belongs to the Special Issue Stereotactic Body Radiotherapy)
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