BJMO - volume 9, issue 3, july 2015
D. De Ruysscher MD, PhD, W. de Neve MD, PhD
Heavy ion therapy is an emerging technique in radiotherapy. It provides highly conformal dose distributions compared to those currently used with photons. These superior beam properties allow increasing the target dose without enhancing the dose to critical structures and/or offer the possibility to reduce the dose to critical structures without compromising the dose to the target. Proton therapy infrastructure is being implemented and carbon or other ion therapy, which, in addition to its physical conformity is also biologically very attractive, has become available as well.
(BELG J MED ONCOL 2015;9(3):87–94)
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BJMO - volume 7, issue 4, september 2013
R. Weytjens , K. Erven MD, PhD, D. De Ruysscher MD, PhD
Summary
Radiation pneumonitis is the most important dose-limiting toxicity in the treatment of thoracic malignancies amendable for high-dose radiotherapy such as lung or oesophageal cancer.
Several patient-specific factors (e.g. age, smoking history, pre-existing inflammatory lung disease, tumour location and performance score) as well as treatment-related factors (e.g. radiation dose and volume, chemotherapy, hormonal therapy) have been studied as potential predictors of the risk of radiation pneumonitis. The most robust parameters that correlate with radiation pneumonitis are Dose Volume Histogram-related, such as the mean lung dose, the percentage of a volume receiving a certain dose such as the V20 and more complex models. All of these show a low overall accuracy with an area under the receiver-operator curve of about 0.65, although they might be still clinically useful by virtue of their high negative predictive value.
Besides research in the underlying genetics of radiation pneumonitis, the interaction between radiotherapy and most targeted agents has not been elucidated.
At present, validated Dose Volume Histogram parameters can be used in clinical practice. Drugs administered concurrently with irradiation of the lungs should only be carried out in combinations with proven safety in prospective trials.
(BELG J MED ONCOL 2013;7(4):105–10)
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