Role of radiation oncology in modern multidisciplinary cancer treatment

Abstract

Cancer care is moving from a disease-focused management toward a patient-centered tailored approach. Multidisciplinary management that aims to define individual, optimal treatment strategies through shared decision making between healthcare professionals and patient is a fundamental aspect of high-quality cancer care and often includes radiation oncology. Advances in technology and radiobiological research allow to deliver ever more tailored radiation treatments in an ever easier and faster way, thus improving the efficacy, safety, and accessibility of radiation therapy. While these changes are improving quality of cancer care, they are also enormously increasing complexity of decision making, thus challenging the ability to deliver quality affordable cancer care. In this review, we provide an updated outline of the role of radiation oncology in the modern multidisciplinary treatment of cancer. Particularly, we focus on the way some developments in key areas of cancer management are challenging multidisciplinary cancer care in the different clinical settings of early, locally advanced, and metastatic disease, thus highlighting some priority areas of research.

Survival Analysis in Single N2 Station Lung Adenocarcinoma: The Prognostic Role of Involved Lymph Nodes and Adjuvant Therapy

“…However, patient selection is a fundamental part of the surgical approach in the case of mediastinal involvement, and the inclusion of these parameters (age as well as performance status or Karnosky index) during multidisciplinary meeting [ 2 , 12 , 25 ] may represent another step for appropriate and tailored treatment strategies for these patients.…”

Radiation nanosensitizers in cancer therapy—From preclinical discoveries to the outcomes of early clinical trials

“… 8 Optimization of the dose intensity delivered and its fractionation have been some of the major improvements, along with the deployment of modalities that have significantly improved the spatial targeting of radiation. 9 , 10 Over the last few years, conventional radiotherapy has progressively been replaced by conformal radiotherapy (CFRT) where the radiation beam is geometrically controlled to fit the tumor shape while sparing the surrounding organs. Additionally, intensity‐modulated radiation therapy (IMRT) has become the gold standard in radiotherapy treatment by allowing a controlled irradiation field shape, like conventionally fractionated radiation therapy (CFRT), but its intensity is also modulated within the irradiated area.…”

“…Today, IMRT is associated with image‐guided radiotherapy and radiotherapy, in general, is now a common component of multidisciplinary cancer care, used in conjunction with surgery and other systemic therapies. 9 …”

Ultra-High Dose Rate FLASH Irradiation Induced Radio-Resistance of Normal Fibroblast Cells Can Be Enhanced by Hypoxia and Mitochondrial Dysfunction Resulting From Loss of Cytochrome C

“…Radiotherapy (RT) makes up an essential part of cancer treatment and more than half of cancer patients receive radiotherapy during treatment (Vozenin et al, 2019a). In conventional radiotherapy, the radiation includes photons, electrons, protons and heavy ions (Valentini et al, 2020). Although major advances in precise treatment delivery and multimodal imaging allowed radiotherapy to apply to more patients, radiation resistance still remains an unsolved clinical problem, thus more powerful and better tolerated radiotherapy was needed (Vozenin et al, 2019a).…”