Intraoperative Radiation Therapy for Breast Cancer: Are We There Yet?

Shah, Chirag

doi:10.1245/s10434-020-09356-y

Cited by 9 publications

(4 citation statements)

References 9 publications

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“…The aim is to eliminate tumor cells; however, there are many side effects ( 133 ). Currently, radiation therapy is widely used and has achieved good efficacy in the clinical treatment of prostate ( 134 ), breast ( 135 ), cervical ( 136 ), and other cancers.…”

Section: Conventional Methods Of Icd Inductionmentioning

confidence: 99%

Research progress in inducing immunogenic cell death of tumor cells

Xie

Wang

2022

Front. Immunol.

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Immunogenic cell death (ICD) is a regulated cell death (RCD) pathway. In response to physical and chemical signals, tumor cells activate specific signaling pathways that stimulate stress responses in the endoplasmic reticulum (ER) and expose damage-associated molecular patterns (DAMPs), which promote antitumor immune responses. As a result, the tumor microenvironment is altered, and many tumor cells are killed. The ICD response in tumor cells requires inducers. These inducers can be from different sources and contribute to the development of the ICD either indirectly or directly. The combination of ICD inducers with other tumor treatments further enhances the immune response in tumor cells, and more tumor cells are killed; however, it also produces side effects of varying severity. New induction methods based on nanotechnology improve the antitumor ability and significantly reduces side effects because they can target tumor cells precisely. In this review, we introduce the characteristics and mechanisms of ICD responses in tumor cells and the DAMPs associated with ICD responses, summarize the current methods of inducing ICD response in tumor cells in five distinct categories: chemical sources, physical sources, pathogenic sources, combination therapies, and innovative therapies. At the same time, we introduce the limitations of current ICD inducers and make a summary of the use of ICD responses in clinical trials. Finally, we provide an outlook on the future of ICD inducer development and provide some constructive suggestions.

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Section: Conventional Methods Of Icd Inductionmentioning

confidence: 99%

Research progress in inducing immunogenic cell death of tumor cells

Xie

Wang

2022

Front. Immunol.

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“…В доказательной базе в отношении эффективности ИОЛТ имеются 2 проспективных мультицентровых исследования -TARGIT и ELIOT, период наблюдения в них составлял не менее 5 лет [23,24]. Результаты ELIOT показали, что те, кто получал ИОЛТ, по сравнению с теми, у кого молочная железа была облучена полностью, имели больший риск развития локального рецидива [25].…”

Section: Reviewsunclassified

Combined modality treatment of early breast cancer. Literature review

Akhmetzyanov,

Akhmetzyanova,

Ankhimova

et al. 2024

Sib. onkol. ž.

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The object of the study was to conduct a systematic literature review on combined modality treatment for early-stage breast cancer using postoperative and intraoperative radiation therapy, and consider new treatment approaches for early breast cancer.Material and Methods. The search for sources relevant to the review topic was carried out in the Medline, Cochrane Library, and Elibrary systems. A total of 905 studies on combination treatments for early breast cancer were identified, of which 43 were included in the review.Results. Data analysis showed that the rate of local relapses in early breast cancer was lower in patients who underwent breast-conserving surgery in combination with adjuvant radiation therapy than in patients without adjuvant radiation therapy. Research is ongoing on radiotherapy deintensification using intraoperative radiation therapy for patients at low risk of recurrence. Ongoing clinical trials support the omission of radiotherapy after breast-conserving surgery for elderly women with hormone receptor-positive early-stage breast cancer, who receive adjuvant endocrine therapy. Understanding the characteristics of the tumor process will allow us to personalize the treatment of patients with early breast cancer, reduce the risk of local relapses, and avoid unnecessary treatment-related complications.Conclusion. To improve survival in breast cancer patients is only possible by maximizing the tumor control. The effectiveness of adjuvant radiation therapy, which is an integral component in the combined modality treatment of early breast cancer, has been proven. However, third-generation studies discuss the feasibility of identifying a low-risk group of patients with a favorable clinical prognosis, who receive adequate endocrine therapy, and additional radiation do not provide a significant survival benefit.

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“…Of note, in the second TARGIT stratum, delayed intraoperative radiotherapy delivered at a median of 37 days at a second surgery failed to demonstrate non-inferiority to standard whole breast irradiation [64]. Although the TARGIT-IORT procedure has been incorporated into clinical practice globally [65], by and large, the intraoperative radiotherapy approach is still regarded as investigational until mature, long-term data becomes available [66,67].…”

Section: De-intensification Of Radiation In Early Breast Cancer: Hypo...mentioning

confidence: 99%

Recent Advances in Optimizing Radiation Therapy Decisions in Early Invasive Breast Cancer

Riaz

Jeen

Whelan

et al. 2023

Cancers

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Adjuvant whole breast irradiation after breast-conserving surgery is a well-established treatment standard for early invasive breast cancer. Screening, early diagnosis, refinement in surgical techniques, the knowledge of new and specific molecular prognostic factors, and now the standard use of more effective neo/adjuvant systemic therapies have proven instrumental in reducing the rates of locoregional relapses. This underscores the need for reliably identifying women with such low-risk disease burdens in whom elimination of radiation from the treatment plan would not compromise oncological safety. This review summarizes the current evidence for radiation de-intensification strategies and details ongoing prospective clinical trials investigating the omission of adjuvant whole breast irradiation in molecularly defined low-risk breast cancers and related evidence supporting the potential for radiation de-escalation in HER2+ and triple-negative clinical subtypes. Furthermore, we discuss the current evidence for the de-escalation of regional nodal irradiation after neoadjuvant chemotherapy. Finally, we also detail the current knowledge of the clinical value of stromal tumor-infiltrating lymphocytes and liquid-based biomarkers as prognostic factors for locoregional relapse.

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Intraoperative Radiation Therapy for Breast Cancer: Are We There Yet?

Cited by 9 publications

References 9 publications

Research progress in inducing immunogenic cell death of tumor cells

Research progress in inducing immunogenic cell death of tumor cells

Combined modality treatment of early breast cancer. Literature review

Recent Advances in Optimizing Radiation Therapy Decisions in Early Invasive Breast Cancer

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