Radiotherapy articles within Nature Reviews Clinical Oncology

Featured

  • Review Article |

    PET has evolved from a purely diagnostic imaging technique to a multifunctional modality that can provide diverse information of relevance to oncological management. This modality might offer the potential to improve patient care and outcomes by enabling better disease characterization, treatment-response monitoring, and follow-up assessment. Herein, the authors discuss the data supporting the use of PET in personalizing the clinical management of patients with locally advanced and metastatic non-small-cell lung cancer.

    • Willem Grootjans
    • , Lioe-Fee de Geus-Oei
    •  & Johan Bussink

  • News & Views |

    Although radiotherapy is a key component of cancer treatment, provision of this modality is not immune to limits placed on health-care expenditure. Recent studies suggest European radiation oncology resources will generally be insufficient to meet future, and in some cases current, needs. This challenge and how it might be addressed is discussed herein.

    • Jens Overgaard

  • Opinion |

    Patients with oligometastases who develop a small number of metastatic lesions might achieve long-term survival with the use of ablative surgery or stereotactic radiotherapy. More patients are receiving aggressive treatment for oligometastatic disease, yet long-term survival might not be due to the treatments themselves, but rather to the selection of patients with slow-growing indolent disease. The authors examine the key evidence supporting or refuting the existence of an oligometastatic state and its appropriate treatment.

    • David A. Palma
    • , Joseph K. Salama
    •  & Ralph Weichselbaum

  • News & Views |

    The recent results of the Early Breast Cancer Trialists' Cooperative Group meta-analysis have demonstrated that post-mastectomy radiotherapy reduces breast cancer recurrence and mortality in women with positive axillary lymph nodes—independently from the number of the lymph nodes involved—with no significant effect in patients with node-negative axillary status.

    • Roberto Orecchia

  • Review Article |

    High-risk prostate cancer includes a heterogeneous group of patients with a range of prognoses, with some that can be fatal. The optimal management of this patient subgroup is evolving. We critically evaluate the existing literature focused on defining the high-risk population, the management of patients with high-risk prostate cancer, and future directions to optimize care.

    • Albert J. Chang
    • , Karen A. Autio
    •  & Howard I. Scher

  • Review Article |

    Charged particle therapy (CPT) offers advantages over conventional radiotherapy, such as higher local control of the tumour and the potential for less damage to healthy tissues. Despite the advantages of CPT, only a small number of controlled randomized clinical trials have compared it to conventional radiotherapy. The latest clinical data on the use of CPT, dose calculations and delivery, cost-effectiveness issues, current status, and future directions are discussed.

    • Jay S. Loeffler
    •  & Marco Durante

  • Review Article |

    In selected patients with early stage breast cancer, accelerated partial breast irradiation (APBI) has emerged as an alternative treatment option to whole breast irradiation. The authors of this article review the available modalities, patient selection criteria and consensus guideline recommendations, and current controversies in APBI, and discuss why it has become an accepted therapy for suitably selected patients outside of clinical trials.

    • John A. Cox
    •  & Todd A. Swanson

  • News & Views |

    Radiotherapy is known to cause heart disease. A recent analysis challenges several long-held tenets, indicating that radiation-induced cardiotoxicity might occur at lower doses, and earlier, than generally believed. We must be mindful of this toxicity and limit cardiac radiation dose as much as possible.

    • Timothy M. Zagar
    •  & Lawrence B. Marks

  • News & Views |

    Analysis of the radiotherapy facilities in 33 European countries has shown considerable disparity across the continent, with countries in eastern and southeastern Europe being largely underequipped compared with northern and western countries. Timely investment in the radiotherapy infrastructure is required to address the growing burden of cancer care.

    • Suresh Senan
    •  & Ben J. Slotman

  • Year in Review |

    In 2012, advances in molecular profiling of primary brain tumours allowed identification of subgroups of glioma and medulloblastoma that were associated with distinct prognoses and predicted treatment response. Adjuvant chemotherapy is now established for 1p/19q co-deleted anaplastic oligodendrogliomas, and may be the preferred treatment in elderly patients with glioblastoma with a methylated MGMT promoter.

    • Roger Stupp
    •  & Monika E. Hegi

  • Year in Review |

    In the past year, long-term follow-up of trials have confirmed and disproved paradigms in the treatment of colorectal cancer, and identified a chemoprevention agent. In metastatic disease, chemotherapy in unresected primary tumours was studied, and randomized phase III trials introduced new therapy options. Molecular characterization of colon and rectal tumours offers new drug targets.

    • Christina Wu
    •  & Richard M. Goldberg

  • News & Views |

    Preoperative 5-fluorouracil-based chemoradiation with optimal surgery provides very effective local control in locally advanced rectal cancer. Does adding oxaliplatin as a radiosensitizer provide any additional benefit? Is more always better?

    • Rob L. H. Jansen
    •  & Geerard L. Beets

  • Timeline |

    Radiotherapy has been driven by constant technological advances since the discovery of X rays in 1895. This Timeline article covers the history of radiotherapy and focuses on the advances of major importance in the past two decades. These changes have provided clinical benefit for patients with cancer.

    • Juliette Thariat
    • , Jean-Michel Hannoun-Levi
    •  & Jean-Pierre Gérard

  • Review Article |

    Technological innovations have made possible the integration of imaging technology into the radiation treatment devices to increase the precision and accuracy of radiation delivery. But, this is just the beginning. In this Review, David A. Jaffray discusses the different exciting advances in image-guided radiotherapy to achieve patient-specific radiotherapy treatment courses in the ever evolving field of radiation oncology.

    • David A. Jaffray

  • Review Article |

    The emergence of individualized medicine has spurred the need for the development of clinical decision-support systems (CDSSs) based on prediction models of treatment outcome. In radiation oncology, CDSSs combine clinical, imaging and molecular factors to achieve the highest accuracy to predict tumour response. Here, the authors provide an overview of these factors—including survival, recurrence patterns and toxicity—and discuss the methodology behind the multistage development of CDSSs.

    • Philippe Lambin
    • , Ruud G. P. M. van Stiphout
    •  & Andre Dekker

  • Review Article |

    Hypoxia can affect clinical outcome after radiotherapy, resulting in reduced local tumour control and increased malignant progression. Hence, its detection is of utmost importance, but how can we detect hypoxia? Horsman et al. assess the potential use of imaging to identify hypoxic tumours that would lead to treatment modifications with the aim of improving clinical outcome after radiotherapy.

    • Michael R. Horsman
    • , Lise Saksø Mortensen
    •  & Jens Overgaard

  • Review Article |

    Are there any methods beyond MRI for brain tumours imaging? This Review by Andrew C. Peet and colleagues discusses the additional information that can be obtained by using functional imaging methods—such as diffusion imaging, perfusion imaging and magnetic resonance spectroscopy—and the challenges in determining the best way to incorporate these techniques into routine clinical practice.

    • Andrew C. Peet
    • , Theodoros N. Arvanitis
    •  & Adam D. Waldman

  • News & Views |

    A retrospective cohort study has shown that pancreatic radiation is a risk factor for diabetes in survivors of paediatric cancer. This validates and refines prior epidemiological observations of diabetes after radiation to the abdomen and total-body irradiation, and will result in modification of surveillance recommendations in national survivor guidelines.

    • Lillian R. Meacham
    •  & Kimberley J. Dilley

  • Review Article |

    The administration of high-precision radiotherapy, termed stereotactic body radiotherapy (SBRT), delivers high doses of radiation to tumours without greatly affecting adjacent normal tissues. SBRT can affect the disease course for properly selected patients with metastatic cancer with improved palliation, disease response, and long-term disease control. In this Review, the biology, practical aspects of delivery and emerging clinical opportunities for SBRT in limited metastatic cancer patients are discussed.

    • Joseph K. Salama
    • , John P. Kirkpatrick
    •  & Fang-Fang Yin

  • Perspectives |

    Many patients who present with stage III NSCLC are in their 70s with multiple comorbidities who are generally unfit to receive the standard chemoradiotherapy regimen. In this Perspectives article, the author puts forth proposals to advance research within shorter timescales to improve outcomes for patients for whom standard treatment is unavailable.

    • Allan Price

  • News & Views |

    Suboptimal studies had established preoperative chemoradiation as the preferred strategy in the management of localized oesophageal cancer (LEC) and gastro-oesophageal cancer. The recent CROSS trial has now demonstrated considerable benefit from preoperative chemoradiation over surgery alone in patients with LEC. But, are these results only reinforcing advocates of the preoperative chemoradiation strategy?

    • Mariela A. Blum
    •  & Jaffer A. Ajani

  • News & Views |

    Life expectancy of most patients with differentiated thyroid cancer is normal, so adverse treatment effects should be minimized. Lower activities of radioiodine for ablation of thyroid remnants are non-inferior to higher activities and quality of life can be maintained by preparation of radioiodine remnant ablation using recombinant human thyrotropin.

    • Christoph Reiners
    •  & Markus Luster

  • Review Article |

    Hodgkin lymphoma has become one of the most successfully treatable cancers; nevertheless, adverse treatment-related side effects still occur. In this Review, Borchmann et al. discuss the current choices for patients with Hodgkin lymphoma by finding the balance between optimal disease control and the risk of long-term sequelae.

    • Peter Borchmann
    • , Dennis A. Eichenauer
    •  & Andreas Engert

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