Quality of Life and Value Considerations in Head and Neck Proton Beam Therapy: The Holy Grail at Last, or the Quest Continues?

Sher, David J.; Ringash, Jolie

doi:10.1016/j.ijrobp.2015.12.378

Cited by 5 publications

(2 citation statements)

References 6 publications

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“…In practice, the inherent characteristics of protons limit their application to brain metastasis patients. Unlike cost-effectiveness analyses in pediatric populations, analyses in patients with brain metastases who are almost entirely adult and elderly do not currently favor protons [135]. Accurate proton dosimetry is limited by 2 mm to 3 mm and 2% to 3% range uncertainty, which is a clinically meaningful distance in SRS.…”

Section: Proton Therapymentioning

confidence: 99%

Novel Mechanisms and Future Opportunities for the Management of Radiation Necrosis in Patients Treated for Brain Metastases in the Era of Immunotherapy

Vaios

Winter

Shih

et al. 2023

Cancers

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Radiation necrosis, also known as treatment-induced necrosis, has emerged as an important adverse effect following stereotactic radiotherapy (SRS) for brain metastases. The improved survival of patients with brain metastases and increased use of combined systemic therapy and SRS have contributed to a growing incidence of necrosis. The cyclic GMP-AMP (cGAMP) synthase (cGAS) and stimulator of interferon genes (STING) pathway (cGAS-STING) represents a key biological mechanism linking radiation-induced DNA damage to pro-inflammatory effects and innate immunity. By recognizing cytosolic double-stranded DNA, cGAS induces a signaling cascade that results in the upregulation of type 1 interferons and dendritic cell activation. This pathway could play a key role in the pathogenesis of necrosis and provides attractive targets for therapeutic development. Immunotherapy and other novel systemic agents may potentiate activation of cGAS-STING signaling following radiotherapy and increase necrosis risk. Advancements in dosimetric strategies, novel imaging modalities, artificial intelligence, and circulating biomarkers could improve the management of necrosis. This review provides new insights into the pathophysiology of necrosis and synthesizes our current understanding regarding the diagnosis, risk factors, and management options of necrosis while highlighting novel avenues for discovery.

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Section: Proton Therapymentioning

confidence: 99%

Novel Mechanisms and Future Opportunities for the Management of Radiation Necrosis in Patients Treated for Brain Metastases in the Era of Immunotherapy

Vaios

Winter

Shih

et al. 2023

Cancers

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“…In addition, patients with brain metastases represent an almost entirely adult, often elderly, population. Unlike analyses of pediatric patients that show multiple, significant advantages for proton therapy, cost-effectiveness analyses in adults frequently do not favor the utilization of proton therapy (6).…”

mentioning

confidence: 99%

Proton Therapy for Brain Metastases: A Question of Value

Kirkpatrick

Laack

Halasz

et al. 2018

International Journal of Radiation Oncology*Biology*Physics

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Particle Therapy at the “Tipping Point”: An Introduction to the Red Journal's Special Edition

Zietman

2016

International Journal of Radiation Oncology*Biology*Physics

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Quality of Life and Value Considerations in Head and Neck Proton Beam Therapy: The Holy Grail at Last, or the Quest Continues?

Cited by 5 publications

References 6 publications

Novel Mechanisms and Future Opportunities for the Management of Radiation Necrosis in Patients Treated for Brain Metastases in the Era of Immunotherapy

Novel Mechanisms and Future Opportunities for the Management of Radiation Necrosis in Patients Treated for Brain Metastases in the Era of Immunotherapy

Proton Therapy for Brain Metastases: A Question of Value

Particle Therapy at the “Tipping Point”: An Introduction to the Red Journal's Special Edition

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