Editor-in-Chief Emeritus Pick of Papers
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For each issue of Radiotherapy and Oncology, the Editor-in-Chief Emeritus Jens Overgaard, picks his favourite papers.
- A viable alternative for surgery to treat early stage non-small-cell lung cancer is stereotactic body radiation therapy (SBRT) [1,2]. The dose distributions need to be highly conformal around the target to ensure coverage, while sparing adjacent organs at risk (OARs) . Although Intensity Modulated Radiation Therapy (IMRT) produces conformal dose distributions, Volumetric Modulated Arc Therapy (VMAT) can in some cases spare even more tissue with equal target coverage . On C-arm linacs, VMAT typically reduces delivery times when combined with high-dose rate flattening-filter free beams .
- Any cancer that can metastasise to the spinal column or within the epidural space has the potential to cause cord compression. It is well recognised that prostate, breast and lung cancers often metastasise to the spine and these typically make up 45–60% of metastatic spinal cord compression (MSCC) cases . Other less frequent tumours include renal cell carcinoma, multiple myeloma, sarcoma, colorectal cancers, non-Hodgkin lymphoma, and cancers of unknown primary. Table 1 is a representation of tumours causing MSCC, taken from a large systematic review , however this should be viewed with caution as papers included within the systematic review may have excluded certain cancer types.
- After liver and lungs, bone is the third most common metastatic site . Almost all malignancies can metastasize to the skeleton but 80% of bone metastases originate from breast, prostate, lung, kidney and thyroid cancer . Introduction of effective systemic treatment in many cancers has prolonged patients’ survival, including those with bone metastases.
- Surface Guided Radiation Therapy (SGRT) is a relatively recent technology that was added to existing image guidance systems. SGRT typically uses visible structured light, stereo-vision systems, time-of-flight systems, or laser scanners to image the surface of a patient with high temporal and spatial resolution without additional radiation dose [1,2].
- Myeloablative Total Body Irradiation (TBI) has long been a cornerstone of the conditioning for hematopoietic stem cell transplantation (HSCT) in children , but is associated with considerable late effects [2–6]. Currently, use of TBI is mainly indicated in allogeneic HSCT for high-risk hematologic malignancy [7–13]. Fractionated TBI (fTBI) is standard for pediatric radiotherapy centers, but practices vary [14,15]. While most centers perform conventional TBI, several institutions have introduced highly conformal TBI techniques or Total Marrow Irradiation (TMI), Total Lymphoid Irradiation (TLI), and Total Marrow and Lymphoid Irradiation (TMLI) [16–19].
- Two-thirds of the central nervous system tumors, the most common solid neoplasm in children, occur in the posterior fossa. With improvements in surgical technologies, chemotherapy and radiotherapy protocols over the past decades, the 5-year survival rate for children with a posterior fossa tumor (PFT) have increased for the main histological types of tumors diagnosed during childhood. The survival rate is 90% for astrocytoma (30% of PFT), 60% for ependymoma (10% of PFT), and 80% for medulloblastoma (40% of PFT).