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The Role of Stereotactic Ablative Radiotherapy in the Management of...
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The Role of Stereotactic Ablative Radiotherapy in the Management of Localized and Metastatic Cancer

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Therapy".

Deadline for manuscript submissions: closed (31 July 2021) | Viewed by 3158

Special Issue Editors

Dr. David Benjamin Shultz

E-Mail Website
Guest Editor
Department of Radiation Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, ON M5G 2M9, Canada
Interests: spine SBRT (SABR); brain metastases; sarcoma; angiosarcoma; hypoxia; CNS
Dr. Srinivas Raman

E-Mail Website
Guest Editor
Department of Radiation Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, ON M5G 2M9, Canada
Interests: lung SBRT (SABR); prostate SBRT (SABR); artificial intelligence; data science
Dr. Aisling Barry

E-Mail Website
Guest Editor
Department of Radiation Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, ON M5G 2M9, Canada
Interests: liver SBRT (SABR); oligo-metastatses; oligo-progression; palliative radiotherapy; breast cancer

Special Issue Information

Stereotactic ablative radiotherapy (SABR), also referred to as stereotactic body radiotherapy (SBRT), is a technique whereby external beam radiation is delivered in high doses per fraction to a well-defined target, with ablative intent. SABR can be used as curative or palliative treatment. In a definitive setting, such as early stage non-small cell lung cancer, SABR is used to treat the primary tumor with curative intent. In the palliative setting, SABR is used to reduce pain or prevent other complications from progressive growth. Furthermore, SABR has an increasingly important role in the management of oligometastatic cancer, where ablative treatment has been shown to improve survival when compared to standard palliative therapies. Stereotactic treatments require dedicated equipment and highly specialized teams of oncologists, physicists, and therapists to achieve the precision and accuracy necessary for effective and safe treatment delivery. This Special Issue of Cancers will highlight the latest investigations in this critical and rapidly evolving field of oncology.

Dr. David Benjamin Shultz
Dr. Srinivas Raman
Dr. Aisling Barry
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Cancers is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • stereotactic ablative radiotherapy
  • stereotactic body radiotherapy
  • oligometastatic
  • radiation oncology
  • thoracic
  • radiosurgery
  • liver
  • renal
  • pancreas
  • gastrointestinal
  • genitourinary
  • spine

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Published Papers (1 paper)

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Research

12 pages, 1887 KiB  
Article
Continued versus Interrupted Targeted Therapy during Metastasis-Directed Stereotactic Radiotherapy: A Retrospective Multi-Center Safety and Efficacy Analysis
by Stephanie G. C. Kroeze, Corinna Fritz, Jana Schaule, Oliver Blanck, Klaus Henning Kahl, David Kaul, Shankar Siva, Sabine Gerum, An Claes, Nora Sundahl, Sonja Adebahr, Susanne Stera, Markus M. Schymalla, Nasrin Abbasi-Senger, Daniel Buergy, Michael Geier, Marcella Szuecs, Fabian Lohaus, Guido Henke, Stephanie E. Combs and Matthias Guckenbergeradd Show full author list remove Hide full author list
Cancers 2021, 13(19), 4780; https://doi.org/10.3390/cancers13194780 - 24 Sep 2021
Cited by 10 | Viewed by 2335
Abstract
The increasing use of targeted therapy (TT) has resulted in prolonged disease control and survival in many metastatic cancers. In parallel, stereotactic radiotherapy (SRT) is increasingly performed in patients receiving TT to obtain a durable control of resistant metastases, and thereby to prolong [...] Read more.
The increasing use of targeted therapy (TT) has resulted in prolonged disease control and survival in many metastatic cancers. In parallel, stereotactic radiotherapy (SRT) is increasingly performed in patients receiving TT to obtain a durable control of resistant metastases, and thereby to prolong the time to disseminated disease progression and switch of systemic therapy. The aims of this study were to analyze the safety and efficacy of SRT combined with TT in metastatic cancer patients and to assess the influence of continuous vs. interrupted TT during metastasis-directed SRT. The data of 454 SRTs in 158 patients from the international multicenter database (TOaSTT) on metastatic cancer patients treated with SRT and concurrent TT (within 30 days) were analyzed using Kaplan–Meier and log rank testing. Toxicity was defined by the CTCAE v4.03 criteria. The median FU was 19.9 mo (range 1–102 mo); 1y OS, PFS and LC were 59%, 24% and 84%, respectively. Median TTS was 25.5 mo (95% CI 11–40). TT was started before SRT in 77% of patients. TT was interrupted during SRT in 44% of patients, with a median interruption of 7 (range 1–42) days. There was no significant difference in OS or PFS whether TT was temporarily interrupted during SRT or not. Any-grade acute and late SRT-related toxicity occurred in 63 (40%) and 52 (33%) patients, respectively. The highest toxicity rates were observed for the combination of SRT and EGFRi or BRAF/MEKi, and any-grade toxicity was significantly increased when EGFRi (p = 0.016) or BRAF/MEKi (p = 0.009) were continued during SRT. Severe (≥grade 3) acute and late SRT-related toxicity were observed in 5 (3%) and 7 (4%) patients, respectively, most frequently in patients treated with EGFRi or BRAF/MEKi and in the intracranial cohort. There was no significant difference in severe toxicity whether TT was interrupted before and after SRT or not. In conclusion, SRT and continuous vs. interrupted TT in metastatic cancer patients did not influence OS or PFS. Overall, severe toxicity of combined treatment was rare; a potentially increased toxicity after SRT and continuous treatment with EGFR inhibitors or BRAF(±MEK) inhibitors requires further evaluation. Full article
(This article belongs to the Special Issue The Role of Stereotactic Ablative Radiotherapy in the Management of Localized and Metastatic Cancer)
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