How Stereotactic Radiotherapy Changed the Landscape in Cancer Care

Kinj, Rémy; Bourhis, Jean

doi:10.3390/cancers15061734

Cited by 5 publications

(6 citation statements)

References 20 publications

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“…This approach may lead to gradual metabolic normalization and a steady stress response. In contrast, SBRT delivers higher doses in fewer fractions, resulting in acute and intense metabolic stress [47]. Moreover, CFRT affects a broader area, including surrounding healthy tissue, leading to extensive metabolic alterations as both tumor and normal cells respond to the radiation.…”

Section: Discussionmentioning

confidence: 99%

Combining Metabolomics and Machine Learning to Identify Diagnostic and Prognostic Biomarkers in Patients with Non-Small Cell Lung Cancer Pre- and Post-Radiation Therapy

Murcia-Mejía,

Canela-Capdevila,

García-Pablo

et al. 2024

Preprint

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Lung cancer is the leading cause of cancer-related deaths globally, with non-small cell lung cancer (NSCLC) accounting for over 85% of cases and poor prognosis in advanced stages. This study explored shifts in circulating metabolite levels in NSCLC patients versus healthy controls and examined the effects of conventionally fractionated radiation therapy (CFRT) and stereotactic body radiation therapy (SBRT). We enrolled 91 NSCLC patients (38 CFRT and 53 SBRT) and 40 healthy controls. Plasma metabolite levels were assessed using semi-targeted metabolomics, revealing 32 elevated and 18 reduced metabolites in patients. Key discriminatory metabolites included ethylmalonic acid, maltose, 3-phosphoglyceric acid, taurine, glutamic acid, glycocolic acid, and d-arabinose, with a combined Receiver Operating Characteristics curve indicating perfect discrimination between patients and controls. CFRT and SBRT affected different metabolites, but both changes suggested a partial normalization of energy and amino acid metabolism pathways. In conclusion, metabolomics identified distinct metabolic signatures in NSCLC patients with potential as diagnostic biomarkers. The differing metabolic responses to CFRT and SBRT reflect their unique therapeutic impacts, underscoring the utility of this technique in enhancing NSCLC diagnosis and treatment monitoring.

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Section: Discussionmentioning

confidence: 99%

Combining Metabolomics and Machine Learning to Identify Diagnostic and Prognostic Biomarkers in Patients with Non-Small Cell Lung Cancer Pre- and Post-Radiation Therapy

Murcia-Mejía,

Canela-Capdevila,

García-Pablo

et al. 2024

Preprint

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“…Stereotactic body radiation therapy (SBRT) is considered a non-invasive treatment option for patients who are not suitable for surgery or refuse surgery. This treatment delivers high doses of radiation to the tumor with minimal damage to surrounding tissues [17]. SBRT has been shown to be effective in controlling local disease and achieving high rates of survival in select patients.…”

Section: Stereotactic Body Radiation Therapymentioning

confidence: 99%

Advances in the Treatment of Pulmonary Nodules

Zhang,

Wu,

Yang

et al. 2024

Respiration

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Background: Early detection and accurate diagnosis of pulmonary nodules are crucial for improving patient outcomes. While surgical resection of malignant nodules is still the preferred treatment option, it may not be feasible for all patients. We aimed to discuss the advances in the treatment of pulmonary nodules, especially stereotactic body radiotherapy (SBRT) and interventional pulmonology technologies, and provide a range of recommendations based on our expertise and experience. Summary: Interventional pulmonology is an increasingly important approach for the management of pulmonary nodules. While more studies are needed to fully evaluate its long-term outcomes and benefits, the available evidence suggests that this technique can provide a minimally invasive and effective alternative for treating small malignancies in selected patients. We conducted a systematic literature review in PubMed, designed a framework to include the advances in surgery, SBRT, and interventional pulmonology for the treatment of pulmonary nodules, and provided a range of recommendations based on our expertise and experience. Key Messages: As such, alternative therapeutic options such as SBRT and ablation are becoming increasingly important and viable. With recent advancements in bronchoscopy techniques, ablation via bronchoscopy has emerged as a promising option for treating pulmonary nodules. This study reviewed the advances of interventional pulmonology in the treatment of peripheral lung cancer patients that are not surgical candidates. We also discussed the challenges and limitations associated with ablation, such as the risk of complications and the potential for incomplete nodule eradication. These advancements hold great promise for improving the efficacy and safety of interventional pulmonology in treating pulmonary nodules.

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“…In 2016, the International Gamma Knife Research Foundation (IGKRF) published the results of a multi-institutional retrospective study of 547 patients (596 BSM) [56]. They reported a local control rate of 81.8% at 1 year and an overall grade 3-4 toxicity rate of 7.4%, with no grade V. The primary histologies were NSCLC and breast cancer; 49% had previously received WBRT; the median BSM volume was 0.8 (0.01-21) mL; and they were treated with a median margin dose of 16 (8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25) Gray. According to their findings, three variables-age (≥65), a margin dose of <16 Gy (vs. ≥20 Gy), and a maximum dose-were associated with a significantly increased risk of local failure.…”

Section: Brainstem Lesions: Reaching the Limits Of Srtmentioning

confidence: 99%

“…An increasing number of local tumors are being treated with Stereotactic Body Radiotherapy (SBRT) instead of surgery, but conclusive evidence of the advantages of SBRT over surgery is still lacking [ 18 ]. Given its potential for low-toxicity tumor ablation and its ability to be effective in combination with systemic treatments such as immunotherapy, SBRT is becoming a more widely used treatment [ 18 ]. It should be emphasized that SRS-SRT requires resources, training, and widely available equipment (e.g., magnetic resonance imaging) with accurate and reliable systems.…”

Section: Introductionmentioning

confidence: 99%

“…SRS can be delivered in two different forms: either as a single dose (18-24 Gy), or in three fractions of 24-27 Gy or [30][31][32][33][34][35] Gy in five fractions [3]. An increasing number of local tumors are being treated with Stereotactic Body Radiotherapy (SBRT) instead of surgery, but conclusive evidence of the advantages of SBRT over surgery is still lacking [18]. Given its potential for low-toxicity tumor ablation and its ability to be effective in combination with systemic treatments such as immunotherapy, SBRT is becoming a more widely used treatment [18].…”

Section: Introductionmentioning

confidence: 99%

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Stereotactic Radiosurgery and Stereotactic Fractionated Radiotherapy in the Management of Brain Metastases

Benkhaled,

Schiappacasse,

Awde

et al. 2024

Cancers

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The management of brain metastases (BM) remains an important and complex issue in the treatment of cancer-related neurological complications. BM are particularly common in patients diagnosed with lung, melanoma, or breast cancer. Over the past decade, therapeutic approaches for the majority of BM patients have changed. Considering and addressing the fact that patients with BM are living longer, the need to provide effective local control while preserving quality of life and neurocognition is fundamental. Over the past decade, SRS and SRT have become a more commonly chosen treatment option for BM. Despite significant advances in the treatment of BM, numerous questions remain regarding patient selection and optimal treatment sequencing. Clinical trials are critical to advancing our understanding of BM, especially as more therapeutic alternatives become available. Therefore, it is imperative for interdisciplinary teams to improve their understanding of the latest advances in SRS-SRT. This review aims to comprehensively explore SRS and SRT as treatments for BM, covering clinical considerations in their application (e.g., patient selection and eligibility), managing limited and multiple intact BM, addressing brainstem metastases, exploring combination therapies with systemic treatments, and considering the health economic perspective.

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How Stereotactic Radiotherapy Changed the Landscape in Cancer Care

Abstract: The term “stereotactic body radiotherapy” (SBRT) refers to high-precision radiotherapy techniques using numerous beams converging in a small target volume, allowing the delivery of high doses per fraction (>6–7 Gy) in a very few number of fractions [...]

Cited by 5 publications

References 20 publications

Combining Metabolomics and Machine Learning to Identify Diagnostic and Prognostic Biomarkers in Patients with Non-Small Cell Lung Cancer Pre- and Post-Radiation Therapy

Combining Metabolomics and Machine Learning to Identify Diagnostic and Prognostic Biomarkers in Patients with Non-Small Cell Lung Cancer Pre- and Post-Radiation Therapy

Advances in the Treatment of Pulmonary Nodules

Stereotactic Radiosurgery and Stereotactic Fractionated Radiotherapy in the Management of Brain Metastases

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