1
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Iorio GC, Martini S, Arcadipane F, Ricardi U, Franco P. The role of radiotherapy in epithelial ovarian cancer: a literature overview. Med Oncol 2019; 36:64. [PMID: 31165334 DOI: 10.1007/s12032-019-1287-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Accepted: 05/28/2019] [Indexed: 12/24/2022]
Abstract
Ovarian cancer (OC) accounts for 3% of all cancer in women and for 5% of all cancer-related deaths. Epithelial Ovarian Cancer (EOC) is a radiosensitive malignancy with a poor prognosis. In the pre-chemotherapy era, radiation therapy (RT) delivered to the abdominopelvic region (whole abdominal irradiation, WAI) has historically played a role in the adjuvant and consolidation setting. Specific cluster of patients with early-stage disease and definite histologies may take advantage of RT. Platinum-based chemotherapy (CT) has replaced RT and plays a major role in most of the clinical settings. Radiation Therapy for palliation is recommended in patients with localized symptoms. Nevertheless, modern RT represents a reliable treatment option, with a mild toxicity profile, particularly effective for oligo-recurrent or progressive disease. The present literature review aims to highlight the historical role of RT in EOC, the actual lines of evidence, and the future perspectives.
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Affiliation(s)
- Giuseppe Carlo Iorio
- Department of Oncology, Radiation Oncology, School of Medicine, University of Turin, Via Genova 3, 10126, Turin, Italy
| | - Stefania Martini
- Department of Oncology, Radiation Oncology, School of Medicine, University of Turin, Via Genova 3, 10126, Turin, Italy
| | - Francesca Arcadipane
- Department of Oncology, Radiation Oncology, AOU Citta' della Salute e della Scienza, Turin, Italy
| | - Umberto Ricardi
- Department of Oncology, Radiation Oncology, School of Medicine, University of Turin, Via Genova 3, 10126, Turin, Italy
| | - Pierfrancesco Franco
- Department of Oncology, Radiation Oncology, School of Medicine, University of Turin, Via Genova 3, 10126, Turin, Italy.
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2
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Franco P, Iorio GC, Bartoncini S, Airoldi M, De Sanctis C, Castellano I, Ricardi U. De-escalation of breast radiotherapy after conserving surgery in low-risk early breast cancer patients. Med Oncol 2018; 35:62. [PMID: 29616366 DOI: 10.1007/s12032-018-1121-8] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Accepted: 03/30/2018] [Indexed: 12/12/2022]
Abstract
The reduction in the burden related to treatment is becoming more and more important in modern oncology. Radiation therapy is a mainstay option in the postoperative setting for early breast cancer patients after breast-conserving surgery. Nowadays, different options are available to de-escalate radiotherapy in this scenario such as the use of hypofractionated whole-breast radiation, the selective delivery of the boost dose to the lumpectomy cavity, the introduction of accelerated partial breast irradiation and the omission of treatment in appropriately selected patients with low-risk features. We herein provide a review article on this topic.
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Affiliation(s)
- Pierfrancesco Franco
- Department of Oncology, Radiation Oncology, University of Turin, Via Genova 3, 10126, Turin, Italy.
| | - Giuseppe Carlo Iorio
- Department of Oncology, Radiation Oncology, University of Turin, Via Genova 3, 10126, Turin, Italy
| | - Sara Bartoncini
- Department of Oncology, Radiation Oncology, AOU Citta' della Salute e della Scienza, Turin, Italy
| | - Mario Airoldi
- Department of Medical Sciences, Pathology Unit, University of Turin, Turin, Italy
| | - Corrado De Sanctis
- Department of Gynecology and Obstetrics, Breast Unit, AOU Città della Salute e della Scienza, Turin, Italy
| | - Isabella Castellano
- Department of Oncology, Medical Oncology 2, AOU Città della Salute e della Scienza, Turin, Italy
| | - Umberto Ricardi
- Department of Oncology, Radiation Oncology, University of Turin, Via Genova 3, 10126, Turin, Italy
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3
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Franco P, Zeverino M, Migliaccio F, Torielli P, Angelini V, Sciacero P, Girelli G, Cante D, Arrichiello C, Borca VC, Numico G, La Porta MR, Tofani S, Ricardi U. Minimizing a Tricky Situation in Breast Irradiation with Helical Tomotherapy. TUMORI JOURNAL 2018; 100:e35-40. [DOI: 10.1177/030089161410000221] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
We report on a patient with breast cancer undergoing adjuvant intensity-modulated whole breast and lymph node irradiation with static angle tomotherapy (TomoDirect), who experienced a traumatic ipsilateral humeral fracture and was able to continue radiotherapy with helical tomotherapy and daily dosimetric monitoring by means of the Planned Adaptive module.
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Affiliation(s)
- Pierfrancesco Franco
- Radiation Oncology Department, Tomotherapy Unit, Ospedale Regionale “U Parini”, AUSL Valle d'Aosta, Aosta
| | - Michele Zeverino
- Medical Physics Department, Ospedale Regionale “U Parini”, AUSL Valle d'Aosta, Aosta
| | - Fernanda Migliaccio
- Radiation Oncology Department, Tomotherapy Unit, Ospedale Regionale “U Parini”, AUSL Valle d'Aosta, Aosta
| | - Paolo Torielli
- Radiation Oncology Department, Tomotherapy Unit, Ospedale Regionale “U Parini”, AUSL Valle d'Aosta, Aosta
| | - Veronica Angelini
- Radiation Oncology Department, Tomotherapy Unit, Ospedale Regionale “U Parini”, AUSL Valle d'Aosta, Aosta
| | - Piera Sciacero
- Radiation Oncology Department, Tomotherapy Unit, Ospedale Regionale “U Parini”, AUSL Valle d'Aosta, Aosta
| | - Giuseppe Girelli
- Radiation Oncology Department, Tomotherapy Unit, Ospedale Regionale “U Parini”, AUSL Valle d'Aosta, Aosta
| | - Domenico Cante
- Radiation Oncology Department, Tomotherapy Unit, Ospedale Regionale “U Parini”, AUSL Valle d'Aosta, Aosta
| | - Cecilia Arrichiello
- Medical Physics Department, Ospedale Regionale “U Parini”, AUSL Valle d'Aosta, Aosta
| | | | - Gianmauro Numico
- Medical Oncology Department, Ospedale Regionale “U Parini”, AUSL Valle d'Aosta, Aosta
| | - Maria Rosa La Porta
- Radiation Oncology Department, Tomotherapy Unit, Ospedale Regionale “U Parini”, AUSL Valle d'Aosta, Aosta
| | - Santi Tofani
- Medical Physics Department, Ospedale Regionale “U Parini”, AUSL Valle d'Aosta, Aosta
| | - Umberto Ricardi
- Medical Physics Department, Ospedale Regionale “U Parini”, AUSL Valle d'Aosta, Aosta
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Numico G, Fusco V, Franco P, Roila F. Proton Pump Inhibitors in cancer patients: How useful they are? A review of the most common indications for their use. Crit Rev Oncol Hematol 2017; 111:144-151. [DOI: 10.1016/j.critrevonc.2017.01.014] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2016] [Revised: 01/02/2017] [Accepted: 01/23/2017] [Indexed: 02/08/2023] Open
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Franco P, Arcadipane F, Ragona R, Mistrangelo M, Cassoni P, Racca P, Morino M, Numico G, Ricardi U. Hematologic toxicity in anal cancer patients during combined chemo-radiation: a radiation oncologist perspective. Expert Rev Anticancer Ther 2017; 17:335-345. [PMID: 28277103 DOI: 10.1080/14737140.2017.1288104] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
INTRODUCTION Hematologic toxicity is an important side effect occurring in patients affected with anal cancer, undergoing combined radio-chemotherapy, with consistent clinical meaningfulness. Areas covered: Since more than a half of bone marrow is comprised within the pelvic region, the radiation dose received by this functional compartment is crucial. Modern imaging modalities may provide a useful tool to identify bone marrow and new delivery technology may enhance the radiation oncologist's possibility to selectively spare these structures, potentially decreasing acute hematologic toxicity profile in this setting. Expert commentary: Correlation between dose to pelvic structures and acute hematologic toxicity has been studied in several oncological settings, mainly on a retrospective frame. Different dose metrics were found to be correlated including mean doses and different points within the dose-volume histogram ranging from low to medium-high doses. Several imaging modalities were used to identify bone marrow both morphological and functional. Several clinical endpoints were used. In general, accounting for bone marrow during the treatment planning process may be important to decrease the acute hematologic toxicity profile during concurrent chemo-radiation in anal cancer patients. The most appropriate strategy to address this issue need further investigation and deserve validation in a prospective clinical framework.
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Affiliation(s)
- Pierfrancesco Franco
- a Department of Oncology, Radiation Oncology , University of Turin , Turin , Italy
| | - Francesca Arcadipane
- a Department of Oncology, Radiation Oncology , University of Turin , Turin , Italy
| | - Riccardo Ragona
- a Department of Oncology, Radiation Oncology , University of Turin , Turin , Italy
| | | | - Paola Cassoni
- c Department of Medical Sciences , University of Turin , Turin , Italy
| | - Patrizia Racca
- d Department of Oncology , Oncological Centre for Gastrointestinal Neoplasm, AOU Città della Salute e della Scienza , Turin , Italy
| | - Mario Morino
- b Department of Surgical Sciences , University of Turin , Turin , Italy
| | - Gianmauro Numico
- e Department of Oncology , Medical Oncology, AO SS Antonio e Biagio e Cesare Arrigo , Alessandria , Italy
| | - Umberto Ricardi
- a Department of Oncology, Radiation Oncology , University of Turin , Turin , Italy
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Management of acute skin toxicity with Hypericum perforatum and neem oil during platinum-based concurrent chemo-radiation in head and neck cancer patients. Med Oncol 2017; 34:30. [DOI: 10.1007/s12032-017-0886-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2017] [Accepted: 01/10/2017] [Indexed: 11/26/2022]
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Arcadipane F, Franco P, De Colle C, Rondi N, Di Muzio J, Pelle E, Martini S, Ala A, Airoldi M, Donadio M, De Sanctis C, Castellano I, Ragona R, Ricardi U. Hypofractionation with no boost after breast conservation in early-stage breast cancer patients. Med Oncol 2016; 33:108. [DOI: 10.1007/s12032-016-0821-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Accepted: 08/13/2016] [Indexed: 01/16/2023]
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Villa A, Sonis ST. Pharmacotherapy for the management of cancer regimen-related oral mucositis. Expert Opin Pharmacother 2016; 17:1801-7. [PMID: 27477002 DOI: 10.1080/14656566.2016.1217993] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Oral mucositis is a frequent and devastating toxicity secondary to cancer treatment, which may affect 20-40% of patients receiving conventional chemotherapy and 60-85% of patients undergoing hematopoietic stem cell transplantation. The pathobiology of mucositis includes a complex cascade of biologic events in which pro-inflammatory cytokines, ROS, second messengers, and the oral microbiome contribute to tissue damage of the oral mucosa. Management strategies to oral mucositis secondary to chemotherapy include preventative measures and therapeutic approaches. AREA COVERED A literature search of published animal and clinical studies was perform to review the epidemiology, pathophysiology and treatment options for cancer regimen-induced mucositis. We also discuss new data coming from recent pertinent clinical trials. EXPERT OPINION Mucositis is one of the most common debilitating toxicities secondary to cancer treatment and can adversely affect patients' quality of life. Epidemiological data for mucositis are often under-reported. Research efforts have shown that genetics plays a major role in the development of this toxicity. Although few therapeutic agents are available, several promising drugs are under investigations.
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Affiliation(s)
- Alessandro Villa
- a Division of Oral Medicine and Dentistry , Brigham and Women's Hospital , Boston , MA , USA.,b Department of Oral Medicine, Infection and Immunity , Harvard School of Dental Medicine , Boston , MA , USA
| | - Stephen T Sonis
- a Division of Oral Medicine and Dentistry , Brigham and Women's Hospital , Boston , MA , USA.,b Department of Oral Medicine, Infection and Immunity , Harvard School of Dental Medicine , Boston , MA , USA.,c Biomodels, LLC , Watertown , MA , USA
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9
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Bilateral Breast Radiation Delivered with Static Angle Tomotherapy (TomoDirect): Clinical Feasibility and Dosimetric Results of a Single Patient. TUMORI JOURNAL 2015; 101:e4-8. [DOI: 10.5301/tj.5000264] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/03/2014] [Indexed: 11/20/2022]
Abstract
We herein report on a case of synchronous bilateral breast cancer patient undergoing adjuvant intensity-modulated whole breast with static angle tomotherapy (TomoDirect). The patient was treated with a hypofractionated schedule employing a simultaneous integrated boost approach. Radiotherapy schedule was 45 Gy/20 fractions (2.25 Gy daily) to the bilateral whole breast and 50 Gy/20 fractions (2.5 Gy daily) to the 2 lumpectomy cavities. Treatment was delivered over 4 weeks. Dosimetric results were robust with consistent target coverage and adequate normal tissue avoidance. Treatment was generally well-tolerated and acute toxicity profile was mild. The present report highlights the promising clinical feasibility of TomoDirect for bilateral breast irradiation.
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Franco P, Potenza I, Moretto F, Segantin M, Grosso M, Lombardo A, Taricco D, Vallario P, Filippi AR, Rampino M, Ricardi U. Hypericum perforatum and neem oil for the management of acute skin toxicity in head and neck cancer patients undergoing radiation or chemo-radiation: a single-arm prospective observational study. Radiat Oncol 2014; 9:297. [PMID: 25544371 PMCID: PMC4300176 DOI: 10.1186/s13014-014-0297-0] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2014] [Accepted: 12/11/2014] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Radiation dermatitis is common in patients treated with combined radiotherapy and chemotherapy for head and neck malignancies. Its timely and adequate management is of uttermost importance for both oncological outcomes and global quality of life. We prospectively evaluated the role of hypericum perforatum and neem oil (Holoil®; RIMOS srl, Mirandola, Italy) in the treatment of acute skin toxicity for patients undergoing radiotherapy or chemo-radiotherapy for head and neck cancer. METHODS A consecutive series of 28 head and neck cancer patients submitted to radiotherapy (RT) was enrolled onto this mono-institutional single-arm prospective observational study. Patients undergoing both definitive or post-operative radiotherapy were allowed, either as exclusive modality or combined with (concomitant or induction) chemotherapy. We started Holoil treatment whenever bright erythema, moderate oedema or patchy moist desquamation were observed. Holoil® was used during all RT course and during follow up time, until acute skin toxicity recovery. RESULTS The maximum detected acute skin toxicity was Grade 1 in 7% of patients, Grade 2 in 68%, Grade 3 in 25%, while at the end of RT was Grade 0 in 3.5%, Grade 1 in 32%, Grade 2 in 61%, Grade 3 in 3.5%. For patients having G2 acute skin toxicity, it mainly started at weeks 4-5; for those having G3, it began during weeks 5-6. Median times spent with G2 or G3 toxicity were 17.5 and 11 days. Patients having G2 acute skin toxicity had a dermatitis worsening in 27% of case (median occurrence time: 7 days). G3 events were reconverted to a G2 profile in all patients (median time: 7 days). Those experiencing a G2 skin event were converted to a G1 score in 23% of cases (median time: 14 days). Time between maximum acute skin toxicity and complete skin recovery after RT was 27 days. CONCLUSIONS Holoil® proved to be a safe and active option in the management of acute skin toxicity in head and neck cancer patients submitted to RT or chemo-radiotherapy. A prophylactic effect in the prevention of moist desquamation may be hypothesized for hypericum and neem oil and need to be tested within a prospective controlled study.
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Affiliation(s)
- Pierfrancesco Franco
- Department of Oncology, Radiation Oncology, University of Turin School of Medicine, Via Genova 3, 10126, Turin, Italy.
| | - Ilenia Potenza
- Department of Oncology, Radiation Oncology, University of Turin School of Medicine, Via Genova 3, 10126, Turin, Italy.
| | - Francesco Moretto
- Radiotherapy Department, AOU Città della Salute e della Scienza, Turin, Italy.
| | - Mattia Segantin
- Department of Oncology, Radiation Oncology, University of Turin School of Medicine, Via Genova 3, 10126, Turin, Italy.
| | - Mario Grosso
- Radiotherapy Department, AOU Città della Salute e della Scienza, Turin, Italy.
| | - Antonello Lombardo
- ENT Surgery Department, AOU Città della Salute e della Scienza, Turin, Italy.
| | - Daniela Taricco
- Radiotherapy Department, AOU Città della Salute e della Scienza, Turin, Italy.
| | - Patrizia Vallario
- Radiotherapy Department, AOU Città della Salute e della Scienza, Turin, Italy.
| | - Andrea Riccardo Filippi
- Department of Oncology, Radiation Oncology, University of Turin School of Medicine, Via Genova 3, 10126, Turin, Italy.
| | - Monica Rampino
- Radiotherapy Department, AOU Città della Salute e della Scienza, Turin, Italy.
| | - Umberto Ricardi
- Department of Oncology, Radiation Oncology, University of Turin School of Medicine, Via Genova 3, 10126, Turin, Italy.
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Cante D, Franco P, Sciacero P, Girelli G, Marra AM, Pasquino M, Russo G, Casanova Borca V, Mondini G, Paino O, Numico G, Tofani S, La Porta MR, Ricardi U. Hypofractionation and concomitant boost to deliver adjuvant whole-breast radiation in ductal carcinoma in situ (DCIS): a subgroup analysis of a prospective case series. Med Oncol 2014; 31:838. [PMID: 24415414 DOI: 10.1007/s12032-014-0838-2] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2013] [Accepted: 01/04/2014] [Indexed: 11/30/2022]
Abstract
To report the four-year outcomes of accelerated hypofractionated whole-breast radiotherapy (WBRT) with a concomitant boost (CB) to the tumor bed in ductal carcinoma in situ (DCIS), we performed a subgroup analysis of 103 patients affected with DCIS within a cohort of 960 early breast cancer patients treated with breast conservation and hypofractionated WBRT. Prescription dose to the whole breast was 45 Gy (2.25 Gy/20 fractions) with an additional daily CB of 0.25 Gy to the surgical cavity (2.5 Gy/20 fractions up to 50 Gy). With a median follow-up of 48 months (range 12-91), no local recurrence was observed. Maximum detected acute skin toxicity was as follows: G0 in 35 % of patients, G1 in 54 %, G2 in 9 % and G3 in 2 %. Late skin and subcutaneous toxicity were generally mild with only 1 % of patients experiencing ≥G3 events (telangiectasia). No major lung and heart toxicity were detected. Cosmetic results were excellent in 50 % of patients, good in 37 %, fair in 9 % and poor in 4 %. Quality of life had a generally favorable profile both within the functioning and symptoms domains. The present result supports the hypothesis that DCIS patients could be safely treated with a hypofractionated schedule employing a CB to the lumpectomy cavity.
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Affiliation(s)
- Domenico Cante
- Radiotherapy Department, ASL TO4, Ivrea Community Hospital, Ivrea, Italy
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12
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Phillips M, Byrnes R, Cataneo RN, Chaturvedi A, Kaplan PD, Libardoni M, Mehta V, Mundada M, Patel U, Ramakrishna N, Schiff PB, Zhang X. Detection of volatile biomarkers of therapeutic radiation in breath. J Breath Res 2013; 7:036002. [PMID: 23793046 DOI: 10.1088/1752-7155/7/3/036002] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Breath testing could provide a rational tool for radiation biodosimetry because radiation causes distinct stress-producing molecular damage, notably an increased production of reactive oxygen species. The resulting oxidative stress accelerates lipid peroxidation of polyunsaturated fatty acids, liberating alkanes and alkane metabolites that are excreted in the breath as volatile organic compounds (VOCs). Breath tests were performed before and after radiation therapy over five days in 31 subjects receiving daily fractionated doses: 180-400 cGy d(-1) standard radiotherapy (n = 26), or 700-1200 cGy d(-1) high-dose stereotactic body radiotherapy (n = 5). Breath VOCs were assayed using comprehensive two-dimensional gas chromatography time-of-flight mass spectrometry. Multiple Monte Carlo simulations identified approximately 50 VOCs as greater-than-chance biomarkers of radiation on all five days of the study. A consistent subset of 15 VOCs was observed at all time points. A radiation response function was built by combining these biomarkers and the resulting dose-effect curve was significantly elevated at all exposures ⩾1.8 Gy. Cross-validated binary algorithms identified radiation exposures ⩾1.8 Gy with 99% accuracy, and ⩾5 Gy with 78% accuracy. In this proof of principal study of breath VOCs, we built a preliminary radiation response function based on 15 VOCs that appears to identify exposure to localized doses of 1.8 Gy and higher. VOC breath testing could provide a new tool for rapid and non-invasive radiation biodosimetry.
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Affiliation(s)
- Michael Phillips
- Breath Research Laboratory, Menssana Research Inc., 211 Warren St, Newark, NJ 07103, USA.
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Abstract
Of the toxicities associated with conventional forms of treatment for head and neck cancers, probably none has such a consistent legacy as oral mucositis.1 Despite the fact that mucosal injury was noted as far back as Marie Curie's first forays into therapeutic radiation, an effective intervention has yet to be developed. In addition to its historic link to radiation, new therapeutic strategies including induction chemotherapy often produce mucositis, and targeted therapies appear to alter mucositis risk and its severity and course.2 The symptomatic effect of oral mucositis is profound. Disabling oral and oropharyngeal pain prevents patients from eating normally, requires opiate analgesics, and in some cases results in alteration or discontinuation of anticancer therapy.3 Furthermore, the health and economic consequences of oral mucositis are far from trivial. The incremental cost of oral mucositis in patients with head and neck cancer exceeds $17,000 (USD).4.
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Affiliation(s)
- Stephen T Sonis
- From the Biomodels, LLC, Brigham and Women's Hospital, and the Dana-Farber Cancer Institute, Boston, MA
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McKenna DJ, Doherty BA, Downes CS, McKeown SR, McKelvey-Martin VJ. Use of the comet-FISH assay to compare DNA damage and repair in p53 and hTERT genes following ionizing radiation. PLoS One 2012; 7:e49364. [PMID: 23145163 PMCID: PMC3492288 DOI: 10.1371/journal.pone.0049364] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2012] [Accepted: 10/09/2012] [Indexed: 12/02/2022] Open
Abstract
The alkaline single cell gel electrophoresis (comet) assay can be combined with fluorescent in situ hybridisation (FISH) methodology in order to investigate the localisation of specific gene domains within an individual cell. The number and position of the fluorescent signal(s) provides information about the relative damage and subsequent repair that is occurring in the targeted gene domain(s). In this study, we have optimised the comet-FISH assay to detect and compare DNA damage and repair in the p53 and hTERT gene regions of bladder cancer cell-lines RT4 and RT112, normal fibroblasts and Cockayne Syndrome (CS) fibroblasts following γ-radiation. Cells were exposed to 5Gy γ-radiation and repair followed for up to 60 minutes. At each repair time-point, the number and location of p53 and hTERT hybridisation spots was recorded in addition to standard comet measurements. In bladder cancer cell-lines and normal fibroblasts, the p53 gene region was found to be rapidly repaired relative to the hTERT gene region and the overall genome, a phenomenon that appeared to be independent of hTERT transcriptional activity. However, in the CS fibroblasts, which are defective in transcription coupled repair (TCR), this rapid repair of the p53 gene region was not observed when compared to both the hTERT gene region and the overall genome, proving the assay can detect variations in DNA repair in the same gene. In conclusion, we propose that the comet-FISH assay is a sensitive and rapid method for detecting differences in DNA damage and repair between different gene regions in individual cells in response to radiation. We suggest this increases its potential for measuring radiosensitivity in cells and may therefore have value in a clinical setting.
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Affiliation(s)
- Declan J McKenna
- Biomedical Sciences Research Institute, University of Ulster, Coleraine, Northern Ireland, United Kingdom.
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Falvo E, Strigari L, Citro G, Giordano C, Boboc G, Fabretti F, Bruzzaniti V, Bellesi L, Muti P, Blandino G, Pinnarò P. SNPs in DNA repair or oxidative stress genes and late subcutaneous fibrosis in patients following single shot partial breast irradiation. JOURNAL OF EXPERIMENTAL & CLINICAL CANCER RESEARCH : CR 2012; 31:7. [PMID: 22272830 PMCID: PMC3285050 DOI: 10.1186/1756-9966-31-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2011] [Accepted: 01/24/2012] [Indexed: 11/10/2022]
Abstract
Background The aim of this study was to evaluate the potential association between single nucleotide polymorphisms related response to radiotherapy injury, such as genes related to DNA repair or enzymes involved in anti-oxidative activities. The paper aims to identify marker genes able to predict an increased risk of late toxicity studying our group of patients who underwent a Single Shot 3D-CRT PBI (SSPBI) after BCS (breast conserving surgery). Methods A total of 57 breast cancer patients who underwent SSPBI were genotyped for SNPs (single nucleotide polymorphisms) in XRCC1, XRCC3, GST and RAD51 by Pyrosequencing technology. Univariate analysis (ORs and 95% CI) was performed to correlate SNPs with the risk of developing ≥ G2 fibrosis or fat necrosis. Results A higher significant risk of developing ≥ G2 fibrosis or fat necrosis in patients with: polymorphic variant GSTP1 (Ile105Val) (OR = 2.9; 95%CI, 0.88-10.14, p = 0.047). Conclusions The presence of some SNPs involved in DNA repair or response to oxidative stress seem to be able to predict late toxicity. Trial Registration ClinicalTrials.gov: NCT01316328
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Affiliation(s)
- Elisabetta Falvo
- Laboratory of Pharmacokinetic/Pharmacogenomic, Regina Elena National Cancer Institute, Rome, Italy.
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Hansson SO. Should we protect the most sensitive people? JOURNAL OF RADIOLOGICAL PROTECTION : OFFICIAL JOURNAL OF THE SOCIETY FOR RADIOLOGICAL PROTECTION 2009; 29:211-218. [PMID: 19454790 DOI: 10.1088/0952-4746/29/2/008] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
The recommendations of the International Commission on Radiological Protection (ICRP) are based on a population average, rather than on the available data for subpopulations. From an ethical point of view, this approach is far from unproblematic. Strong reasons can be given in support of a right for each radiation-exposed person to have the best possible information about the risk to himself or herself, which is often group-specific information. Risk exposures have to be defensible from the perspective of each identifiable group for which a specific risk assessment can be made. Exposing a person to a high risk cannot be justified by pointing out that the risk to an average person would have been much lower. There are two major ways to protect a sensitive group: special standards for the group (differentiated protection) and general standards that are strict enough to protect its members (unified protection). Some major factors that are relevant for the choice between these two protective strategies are identified.
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Affiliation(s)
- Sven Ove Hansson
- Department of Philosophy and the History of Technology, Royal Institute of Technology, Teknikringen 78, 100 44 Stockholm, Sweden.
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Acute normal tissue reactions in head-and-neck cancer patients treated with IMRT: influence of dose and association with genetic polymorphisms in DNA DSB repair genes. Int J Radiat Oncol Biol Phys 2009; 73:1187-95. [PMID: 19251090 DOI: 10.1016/j.ijrobp.2008.08.073] [Citation(s) in RCA: 101] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2008] [Revised: 08/11/2008] [Accepted: 08/11/2008] [Indexed: 12/12/2022]
Abstract
PURPOSE To investigate the association between dose-related parameters and polymorphisms in DNA DSB repair genes XRCC3 (c.-1843A>G, c.562-14A>G, c.722C>T), Rad51 (c.-3429G>C, c.-3392G>T), Lig4 (c.26C>T, c.1704T>C), Ku70 (c.-1310C>G), and Ku80 (c.2110-2408G>A) and the occurrence of acute reactions after radiotherapy. MATERIALS AND METHODS The study population consisted of 88 intensity-modulated radiation therapy (IMRT)-treated head-and-neck cancer patients. Mucositis, dermatitis, and dysphagia were scored using the Common Terminology Criteria (CTC) for Adverse Events v.3.0 scale. The population was divided into a CTC0-2 and CTC3+ group for the analysis of each acute effect. The influence of the dose on critical structures was analyzed using dose-volume histograms. Genotypes were determined by polymerase chain reaction (PCR) combined with restriction fragment length polymorphism or PCR-single base extension assays. RESULTS The mean dose (D(mean)) to the oral cavity and constrictor pharyngeus (PC) muscles was significantly associated with the development of mucositis and dysphagia, respectively. These parameters were considered confounding factors in the radiogenomics analyses. The XRCC3c.722CT/TT and Ku70c.-1310CG/GG genotypes were significantly associated with the development of severe dysphagia (CTC3+). No association was found between the investigated polymorphisms and the development of mucositis or dermatitis. A risk analysis model for severe dysphagia, which was developed based on the XRCC3c.722CT/TT and Ku70c.-1310CG/GG genotypes and the PC dose, showed a sensitivity of 78.6% and a specificity of 77.6%. CONCLUSIONS The XRCC3c.722C>T and Ku70c.-1310C>G polymorphisms as well as the D(mean) to the PC muscles were highly associated with the development of severe dysphagia after IMRT. The prediction model developed using these parameters showed a high sensitivity and specificity.
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Déterminants et facteurs prédictifs pour la radiosensibilité tumorale. Cancer Radiother 2008; 12:3-13. [DOI: 10.1016/j.canrad.2007.11.007] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2007] [Revised: 11/22/2007] [Accepted: 11/23/2007] [Indexed: 11/16/2022]
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Iwata M, Iwakawa M, Noda S, Ohta T, Minfu Y, Kimura T, Shibuya H, Imai T. Correlation between single nucleotide polymorphisms and jejunal crypt cell apoptosis after whole body irradiation. Int J Radiat Biol 2007; 83:181-6. [PMID: 17378526 DOI: 10.1080/09553000601146923] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
PURPOSE To identify loci concerned with radiosensitivity in a mouse model using single nucleotide polymorphism (SNP) markers. MATERIALS AND METHODS We subjected 276 second filial generation (F2) mice descended from two inbred mouse strains, radiation-induced apoptosis sensitive C57BL/6JNrs (B6) and radiation-induced apoptosis resistant C3H/HeNrs (C3H), to 2.5 Gy whole-body irradiation. We quantified jejunal crypt apoptosis, performed a genome-wide survey, and identified quantitative trait loci (QTL) associated with radiation sensitivity. We expressed apoptosis levels as an apoptotic score (AS), which was equal to the number of apoptotic bodies divided by the number of crypts. We genotyped the mice for 109 SNP markers. RESULTS AS values were 97.7+/-32.9 in B6 mice and 49.0+/-24.9 in C3H mice (p < 0.01). Genome-wide analysis revealed 8 markers (2 on chromosome 9, 4 on 15, 1 on 17, and 1 on 18) affecting radiation-induced jejunal apoptosis with log odds (LOD) scores ranging from 2.11+/-3.91. We found a significant locus on chromosome 15, which was previously reported by Weil and colleagues. CONCLUSION These findings support the view that the radiosensitivity of clinically normal tissue depends on variations in several genes.
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Affiliation(s)
- Masaru Iwata
- Radgenomics Project, Frontier Research Center, National Institute of Radiological Sciences, Japan
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