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Chapitre D'ouvrage Année : 2023

Radiobiology of Combining Radiotherapy with Other Cancer Treatment Modalities

Vidhula Ahire
  • Fonction : Auteur
Niloefar Ahmadi Bidakhvidi
  • Fonction : Auteur
Tom Boterberg
  • Fonction : Auteur
Noami Daems
  • Fonction : Auteur
Wendy Delbart
  • Fonction : Auteur
Christophe M Deroose
  • Fonction : Auteur
Nicolaas a P Franken
  • Fonction : Auteur
Lorain Geenen
  • Fonction : Auteur
Nathalie Heynickx
  • Fonction : Auteur
Vinodh Kumar Selvaraj
  • Fonction : Auteur
Hugo Levillain
  • Fonction : Auteur
Anna Jelínek Michaelidesová
  • Fonction : Auteur
  • PersonId : 1288340
Arlene L Oei
  • Fonction : Auteur
Judith Reindl
  • Fonction : Auteur
Peter Sminia
  • Fonction : Auteur
Kevin Tabury
  • Fonction : Auteur
Koen Vermeulen
  • Fonction : Auteur
Kristina Viktorsson
  • Fonction : Auteur
Anthony Waked
  • Fonction : Auteur

Résumé

Abstract In this chapter, we address the role of radiation as treatment modality in the context of oncological treatments given to patients. Physical aspects of the use of ionizing radiation (IR)—by either photons, neutrons, or charged (high linear energy transfer) particles—and their clinical application are summarized. Information is also provided regarding the radiobiological rationale of the use of conventional fractionation as well as alternative fractionation schedules using deviating total dose, fraction size, number of fractions, and the overall treatment time. Pro- and contra arguments of hypofractionation are discussed. In particular, the biological rationale and clinical application of Stereotactic Body Radiation Therapy (SBRT) are described. Furthermore, background information is given about FLASH radiotherapy (RT), which is an emerging new radiation method using ultra-high dose rate allowing the healthy, normal tissues and organs to be spared while maintaining the antitumor effect. Spatial fractionation of radiation in tumor therapy, another method that reduces damage to normal tissue is presented. Normal tissue doses could also be minimized by interstitial or intraluminal irradiation, i.e., brachytherapy, and herein an overview is given on the principles of brachytherapy and its clinical application. Furthermore, details are provided regarding the principles, clinical application, and limitations of boron neutron capture therapy (BNCT). Another important key issue in cancer therapy is the combination of RT with other treatment modalities, e.g., chemotherapy, targeted therapy, immunotherapy, hyperthermia, and hormonal therapy. Combination treatments are aimed to selectively enhance the effect of radiation in cancer cells or to trigger the immune system but also to minimize adverse effects on normal cells. The biological rationale of all these combination treatments as well as their application in clinical settings are outlined. To selectively reach high concentrations of radionuclides in tumor tissue, radioembolization is a highly interesting approach. Also, radioligand therapy which enables specific targeting of cancer cells, while causing minimal harm surrounding healthy tissues is presented. A brief overview is provided on how nanotechnology could contribute to the diagnosis and treatment of cancer. Last but not least, risk factors involved in acquiring secondary tumors after RT are discussed.

Domaines

Cancer
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Dates et versions

hal-04221267 , version 1 (02-10-2023)

Identifiants

Citer

Vidhula Ahire, Niloefar Ahmadi Bidakhvidi, Tom Boterberg, Pankaj Chaudhary, François Chevalier, et al.. Radiobiology of Combining Radiotherapy with Other Cancer Treatment Modalities. Radiobiology Textbook, Springer International Publishing, pp.311 - 386, 2023, ⟨10.1007/978-3-031-18810-7_6⟩. ⟨hal-04221267⟩
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