Improving Patients’ Life Quality after Radiotherapy Treatment by Predicting Late Toxicities

Abstract

Personalized treatment and precision medicine have become the new standard of care in oncology and radiotherapy. Because treatment outcomes have considerably improved over the last few years, permanent side-effects are becoming an increasingly significant issue for cancer survivors. Five to ten percent of patients will develop severe late toxicity after radiotherapy. Identifying these patients before treatment start would allow for treatment adaptation to minimize definitive side effects that could impair their long-term quality of life. Over the last decades, several tests and biomarkers have been developed to identify these patients. However, out of these, only the Radiation-Induced Lymphocyte Apoptosis (RILA) assay has been prospectively validated in multi-center cohorts. This test, based on a simple blood draught, has been shown to be correlated with late radiation-induced toxicity in breast, prostate, cervical and head and neck cancer. It could therefore greatly improve decision making in precision radiation oncology. This literature review summarizes the development and bases of this assay, as well as its clinical results and compares its results to the other available assays.

Performance comparison of ten state-of-the-art machine learning algorithms for outcome prediction modeling of radiation-induced toxicity

“…The use of Shapley values adds a layer of interpretability that is vital for clinical acceptance and application [30]. Clinicians can leverage these insights to understand the key factors influencing toxicity risk, allowing for more informed and personalized patient care strategies [31]. This ability to interpret the predictions given by an algorithm is critical for its credibility and clinical acceptability, and so selecting a model based on the most transparent interpretation may be desirable [32,33].…”

Surface dose measurement and comparison between TLD and OSLD during modified re constructive mastectomy irradiation

“…A time-temperature profile was maintained, employing a heating rate of 10 °C/s from a pre-set temperature of 50 °C to 300 °C, for a duration of 4.5 seconds to record the thermoluminescence glow curve and the integrated thermoluminescence light output. The annealing process of the TL dosimeter was conducted at 400 °C [9,10]. The sensitivity factor (Element Correction Coefficient) was determined for all TL dosimeters with known doses.…”

“…However, breast irradiation can lead to both acute and late side effects such as skin reactions, pain, and heaviness in the breast [3][4][5]. Many studies have suggested that these side effects result from uneven dose distribution within the target area [6][7][8][9]. Therefore, ensuring uniformity in the radiation dose throughout the treatment volume is essential for effectively treating tumours and minimizing adverse side effects.…”

Impact of patient nationality on the severity of early side effects after radiotherapy

“…However, despite the use of optimized and state-of-the-art techniques, co-irradiation of peritumoral tissues is inevitable. Depending on the localization and dose of the ionizing radiation and affected organ sensitivity, a myriad of undesirable and extensive side effects may occur both early (≤ 3 months) and late (> 3 months) after treatment (Welzel and Tanner 2018 ; Lapierre et al 2022 ; Ruysscher et al 2019 ). Although not all patients are equally vulnerable to radiotherapy-related side effects, only a few avoid them (Sonis 2015 ).…”

“…Although not all patients are equally vulnerable to radiotherapy-related side effects, only a few avoid them (Sonis 2015 ). Hence, predicting which patients are most vulnerable to developing severe side effects of radiotherapy is important when personalizing treatment planning to prevent toxicity and improve the quality of life of cancer survivors (Lapierre et al 2022 ).…”