Special Issue "New Directions in Stereotactic Radiotherapy"

A special issue of Current Oncology (ISSN 1718-7729).

Deadline for manuscript submissions: 10 June 2022.

Special Issue Editor

Dr. Brian Yaremko
E-Mail Website
Guest Editor
Schulich School of Medicine & Dentistry, University of Western Ontario, London, ON N6A 3K7, Canada
Interests: stereotactic radiotherapy; lung cancer; breast cancer; functional lung imaging; image fusion

Special Issue Information

Dear colleagues,

Modern clinical oncology continues to experience a rapid and remarkable transformation. We have an ever-increasing understanding of the cellular mechanisms that control the progression of disease, we have systemic therapies that allow us to attack cancer at a molecular level, both via a direct attack upon the internal mechanisms of the cell, as well as by harnessing the body’s own immune system to target and to destroy the disease. In parallel with this, advances in imaging technology have enabled us to identify malignancy earlier, while advances in computing power have enable us to treat even very small, mobile cancers more precisely than ever before.

Stereotactic Body Radiation Therapy (SBRT) implies the delivery of large doses of radiation to very small volumes, in a very short period of time, using sophisticated technology to plan and to deliver the treatment. SBRT has become a valuable adjunct to standard surgery and chemotherapy in some situations, and a viable alternative to surgery in other situations. In a very short time, it has grown from being a highly specialized intervention practiced by only a few centres, becoming a modern standard-of-care at most academic centres. In doing so, SBRT has offered improved outcomes to our patients, and exciting new opportunities to our clinicians and researchers. The burden of cancer continues to grow as and our population continues to age. SBRT is a powerful weapon in our battle against cancers of all types.

The availability of SBRT will continue to expand, along with the indications for its use, and therefore it is critical for radiation oncologists, as well as the larger body of oncologists in general, to understand this exciting treatment modality as thoroughly as possible. This Special Issue therefore aims to provide a thorough review of SBRT, examining its genesis, clinical applications and its emerging relationship to other oncologic treatment modalities, pointing the way forward to the next decade and beyond for this novel, exciting treatment.

Dr. Brian Yaremko
Guest Editor

Manuscript Submission Information

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Keywords

  • stereotactic radiotherapy
  • stereotactic ablative body radiotherapy

Published Papers (1 paper)

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Research

Article
Impact of Pre-Treatment NLR and Other Hematologic Biomarkers on the Outcomes of Early-Stage Non-Small-Cell Lung Cancer Treated with Stereotactic Body Radiation Therapy
Curr. Oncol. 2022, 29(1), 193-208; https://doi.org/10.3390/curroncol29010019 - 04 Jan 2022
Viewed by 162
Abstract
Introduction: We evaluated the association of pre-treatment immunologic biomarkers on the outcomes of early-stage non-small-cell lung cancer (NSCLC) patients treated with stereotactic body radiation therapy (SBRT). Materials and methods: In this retrospective study, all newly diagnosed early-stage NSCLC treated with SBRT between January [...] Read more.
Introduction: We evaluated the association of pre-treatment immunologic biomarkers on the outcomes of early-stage non-small-cell lung cancer (NSCLC) patients treated with stereotactic body radiation therapy (SBRT). Materials and methods: In this retrospective study, all newly diagnosed early-stage NSCLC treated with SBRT between January 2010 and December 2017 were screened and included for further analysis. The pre-treatment neutrophil-lymphocyte ratio (NLR), monocyte lymphocyte ratio (MLR), and platelet-lymphocyte ratio (PLR) were calculated. Overall survival (OS) and recurrence-free survival (RFS) were estimated by Kaplan–Meier. Multivariable models were constructed to determine the impact of different biomarkers and the Akaike information criterion (AIC), index of adequacy, and scaled Brier scores were calculated. Results: A total of 72 patients were identified and 61 were included in final analysis. The median neutrophil count at baseline was 5.4 × 109/L (IQR: 4.17–7.05 × 109/L). Median lymphocyte count was 1.63 × 109/L (IQR: 1.29–2.10 × 109/L), median monocyte count was 0.65 × 109/L (IQR: 0.54–0.83 × 109/L), median platelet count was 260.0 × 109/L (IQR: 211.0–302.0 × 109/L). The median NLR was 3.42 (IQR: 2.38–5.04), median MLR was 0.39 (IQR: 0.31–0.53), and median PLR was 156.4 (IQR: 117.2–197.5). On multivariable regression a higher NLR was associated with worse OS (p = 0.01; HR-1.26; 95% CI 1.04–1.53). The delta AIC between the two multivariable models was 3.4, suggesting a moderate impact of NLR on OS. On multivariable analysis, higher NLR was associated with poor RFS (p = 0.001; NLR^1 HR 0.36; 0.17–0.78; NLR^2 HR-1.16; 95% CI 1.06–1.26) with a nonlinear relationship. The delta AIC between the two multivariable models was 16.2, suggesting a strong impact of NLR on RFS. In our cohort, MLR and PLR were not associated with RFS or OS in multivariable models. Conclusions: Our study suggests NLR, as a biomarker of systemic inflammation, is an independent prognostic factor for OS and RFS. The nonlinear relationship with RFS may indicate a suitable immunological environment is needed for optimal SBRT action and tumoricidal mechanisms. These findings require further validation in independent cohorts. Full article
(This article belongs to the Special Issue New Directions in Stereotactic Radiotherapy)
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