Clinical effects of morning and afternoon radiotherapy on high-grade gliomas

Sapienza, Lucas Gomes; Nasra, Karim; Berry, R. J.; Danesh, Leana; Little, Tania; Abu-Isa, Eyad

doi:10.1080/07420528.2021.1880426

Cited by 15 publications

(18 citation statements)

References 45 publications

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“…A study of brain metastasis in patients with non-small cell lung cancer found a considerable increase in median survival in patients who received radiotherapy before 12:30 h (morning treatment) in comparison with those patients who were treated in the evening [ 101 ]. However, another retrospective study of high-grade gliomas showed no differences in the progression-free survival of patients who received morning radiotherapy versus patients treated in the afternoon [ 102 ].…”

Section: Chronotherapy: a Promising Therapeutic Optionmentioning

confidence: 99%

Chronotherapy: Circadian Rhythms and Their Influence in Cancer Therapy

Amiama-Roig

Verdugo‐Sivianes

Carnero

et al. 2022

Cancers

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Living organisms present rhythmic fluctuations every 24 h in their behavior and metabolism to anticipate changes in the environment. These fluctuations are controlled by a very complex molecular mechanism, the circadian clock, that regulates the expression of multiple genes to ensure the right functioning of the body. An individual’s circadian system is altered during aging, and this is related to numerous age-associated pathologies and other alterations that could contribute to the development of cancer. Nowadays, there is an increasing interest in understanding how circadian rhythms could be used in the treatment of cancer. Chronotherapy aims to understand the impact that biological rhythms have on the response to a therapy to optimize its action, maximize health benefits and minimize possible adverse effects. Clinical trials so far have confirmed that optimal timing of treatment with chemo or immunotherapies could decrease drug toxicity and increase efficacy. Instead, chronoradiotherapy seems to minimize treatment-related symptoms rather than tumor progression or patient survival. In addition, potential therapeutic targets within the molecular clock have also been identified. Therefore, results of the application of chronotherapy in cancer therapy until now are challenging, feasible, and could be applied to clinical practice to improve cancer treatment without additional costs. However, different limitations and variables such as age, sex, or chronotypes, among others, should be overcome before chronotherapy can really be put into clinical practice.

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Section: Chronotherapy: a Promising Therapeutic Optionmentioning

confidence: 99%

Chronotherapy: Circadian Rhythms and Their Influence in Cancer Therapy

Amiama-Roig

Verdugo‐Sivianes

Carnero

et al. 2022

Cancers

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“…The median follow-up was 10.9 months, and the median OS was 16.5 months. There was no difference in OS between HGG patients treated in the morning or in the afternoon [82].…”

Section: Clinical Studiesmentioning

confidence: 74%

“…The hypothesis that the time at which the HGG treatment is carried out may influence the efficacy and/or toxicity of RT has been studied by Sapienza et al [82]. The time of the day the treatment was performed was classified as morning if ≥50% of the fractions were administered before 12:00 or afternoon if after 12:00.…”

Section: Clinical Studiesmentioning

confidence: 99%

Radiotherapy of High-Grade Gliomas: First Half of 2021 Update with Special Reference to Radiosensitization Studies

Fròsina

2021

IJMS

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Albeit the effort to develop targeted therapies for patients with high-grade gliomas (WHO grades III and IV) is evidenced by hundreds of current clinical trials, radiation remains one of the few effective therapeutic options for them. This review article analyzes the updates on the topic “radiotherapy of high-grade gliomas” during the period 1 January 2021–30 June 2021. The high number of articles retrieved in PubMed using the search terms (“gliom* and radio*”) and manually selected for relevance indicates the feverish research currently ongoing on the subject. During the last semester, significant advances were provided in both the preclinical and clinical settings concerning the diagnosis and prognosis of high-grade gliomas, their radioresistance, and the inevitable side effects of their treatment with radiation. The novel information concerning tumor radiosensitization was of special interest in terms of therapeutic perspective and was discussed in detail.

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“…More recent study showed that the daytime (i.e., AM/ PM) of RT delivery did not yield any prognostic impact on progression-free survival (PFS) or OS in high-grade glioma patients. 55 In contrast, patients with HNSCC experienced significant improvements in cause-specific survival when RT was administered in the AM vs. PM (hazard ratio: 1.837, 95% confidence interval: 1.075–3.141; p = .0262). 43 Interestingly, a retrospective study ( n = 617) evaluating the impact of season of RT application for HNSCC found a higher 5-year locoregional control (DARK vs. LIGHT, 73% vs. 61%; p = .0108) and PFS (DARK vs. LIGHT, 51% vs. 43%; p = .0374) when RT was administered in DARK.…”

Section: Chronoradiotherapymentioning

confidence: 96%

Clock in radiation oncology clinics: cost-free modality to alleviate treatment-related toxicity

Ali

Hong

Liu

et al. 2022

Cancer Biology & Therapy

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A large number of studies have reported that tumor cells are often out of sync with the surrounding healthy tissue. Exploiting this misalignment may be a way to obtain a substantial gain in the therapeutic window. Specifically, based on reports to date, we will assess whether radiotherapy outcomes differ depending on the administration time. Collectively, 24 studies met the inclusion criteria, out of which 12 at least reported that radiation therapy is less toxic when administered at a particular time, probably because there is less collateral damage to healthy cells. However, discrepancies exist across studies and urge further investigation. Mechanistic studies elucidating the relationship between radiotherapy, circadian rhythms, and cell cycle, combined with either our “digital” or “biological” chronodata, would help oncologists successfully chronotype individual patients and strategize treatment plans accordingly.

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Clinical effects of morning and afternoon radiotherapy on high-grade gliomas

Cited by 15 publications

References 45 publications

Chronotherapy: Circadian Rhythms and Their Influence in Cancer Therapy

Chronotherapy: Circadian Rhythms and Their Influence in Cancer Therapy

Radiotherapy of High-Grade Gliomas: First Half of 2021 Update with Special Reference to Radiosensitization Studies

Clock in radiation oncology clinics: cost-free modality to alleviate treatment-related toxicity

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