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Combination Treatment of Stereotactic Body Radiation Therapy and Immature Dendritic Cell Vaccination for Augmentation of Local and Systemic Effects
Chul Won Choi, Min Ho Jeong, You-Soo Park, Cheol-Hun Son, Hong-Rae Lee, Eun-Kyoung Koh
Cancer Res Treat. 2019;51(2):464-473.   Published online June 6, 2018
DOI: https://doi.org/10.4143/crt.2018.186
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
The purpose of this study was to investigate the efficacy of stereotactic body radiation therapy (SBRT) as a tumor-associated antigen (TAA) presentation method for dendritic cell (DC) sensitization and evaluate its effect in combination with immunotherapy using an intratumoral injection of immature DCs (iDCs).
Methods
and Materials CT-26 colon carcinoma cell was used as a cancer cell line. Annexin V staining and phagocytosis assays were performed to determine the appropriate radiation dose and incubation time to generate TAAs. BALB/c mice were used for in vivo experiments. Cancer cells were injected into the right legs and left flanks to generate primary and metastatic tumors, respectively. The mice were subjected to radiation therapy (RT) alone, intradermal injection of electroporated DCs alone, or RT in combination with iDC intratumoral injection (RT/iDC). Tumor growth measurement and survival rate analysis were performed. Enzyme-linked immunospot and cytotoxicity assays were performed to observe the effect of different treatments on the immune system.
Results
Annexin V staining and phagocytosis assays showed that 15 Gy radiation dose and 48 hours of incubation was appropriate for subsequent experiments. Maximum DC sensitization and T-cell stimulation was observed with RT as compared to other TAA preparation methods. In vivo assays revealed statistically significant delay in the growth of both primary and metastatic tumors in the RT/iDC group. The overall survival rate was the highest in the RT/iDC group.
Conclusion
The combination of SBRT and iDC vaccination may enhance treatment effects. Clinical trials and further studies are warranted in the future.

Citations

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  • Neoadjuvant SBRT combined with immunotherapy in NSCLC: from mechanisms to therapy
    Yanhong Shi, Xiaoyan Ma, Dan He, Bingwei Dong, Tianyun Qiao
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    Iris A. E. van der Hoorn, Georgina Flórez-Grau, Michel M. van den Heuvel, I. Jolanda M. de Vries, Berber Piet
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    Momotaro Muto, Hirotaka Nakata, Kenichi Ishigaki, Shion Tachibana, Moe Yoshida, Mizue Muto, Nobuyuki Yanagawa, Toshikatsu Okumura
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    Zhihong Sun, Guanjun Deng, Xinghua Peng, Xiuli Xu, Lanlan Liu, Jiaofeng Peng, Yifan Ma, Pengfei Zhang, Austin Wen, Yifan Wang, Zhaogang Yang, Ping Gong, Wen Jiang, Lintao Cai
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    Yin Liao, Shuya Liu, Shaozhi Fu, Jingbo Wu
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    Ben G.L. Vanneste, Evert J Van Limbergen, Ludwig Dubois, Iryna V. Samarska, L. Wieten, M. J.B. Aarts, T. Marcelissen, Dirk De Ruysscher
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    Yang Yang, Hong Ge
    Future Oncology.2020; 16(31): 2537.     CrossRef
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    Hongqing Zhuang
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    Marco Calvaruso, Gaia Pucci, Rosa Musso, Valentina Bravatà, Francesco P. Cammarata, Giorgio Russo, Giusi I. Forte, Luigi Minafra
    International Journal of Molecular Sciences.2019; 20(21): 5267.     CrossRef
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Survey of the Patterns of Using Stereotactic Ablative Radiotherapy for Early-Stage Non-small Cell Lung Cancer in Korea
Sanghyuk Song, Ji Hyun Chang, Hak Jae Kim, Yeon Sil Kim, Jin Hee Kim, Yong Chan Ahn, Jae-Sung Kim, Si Yeol Song, Sung Ho Moon, Moon June Cho, Seon Min Youn
Cancer Res Treat. 2017;49(3):688-694.   Published online October 31, 2016
DOI: https://doi.org/10.4143/crt.2016.219
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
Stereotactic ablative radiotherapy (SABR) is an effective emerging technique for early-stage non-small cell lung cancer (NSCLC). We investigated the current practice of SABR for early-stage NSCLC in Korea.
Materials and Methods
We conducted a nationwide survey of SABR for NSCLC by sending e-mails to all board-certified members of the Korean Society for Radiation Oncology. The survey included 23 questions focusing on the technical aspects of SABR and 18 questions seeking the participants’ opinions on specific clinical scenarios in the use of SABR for early-stage NSCLC. Overall, 79 radiation oncologists at 61/85 specialist hospitals in Korea (71.8%) responded to the survey.
Results
SABR was used at 33 institutions (54%) to treat NSCLC. Regarding technical aspects, the most common planning methods were the rotational intensity-modulated technique (59%) and the static intensity-modulated technique (49%). Respiratory motion was managed by gating (54%) or abdominal compression (51%), and 86% of the planning scans were obtained using 4-dimensional computed tomography. In the clinical scenarios, the most commonly chosen fractionation schedule for peripherally located T1 NSCLC was 60 Gy in four fractions. For centrally located tumors and T2 NSCLC, the oncologists tended to avoid SABR for radiotherapy, and extended the fractionation schedule.
Conclusion
The results of our survey indicated that SABR is increasingly being used to treat NSCLC in Korea. However, there were wide variations in the technical protocols and fractionation schedules of SABR for early-stage NSCLC among institutions. Standardization of SABR is necessary before implementing nationwide, multicenter, randomized studies.

Citations

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  • Guidelines for safe practice of stereotactic body (ablative) radiation therapy: RANZCR 2023 update
    Howard Yu‐hao Liu, Nicholas Hardcastle, Michael Bailey, Shankar Siva, Anna Seeley, Tamara Barry, Jeremy Booth, Louis Lao, Michelle Roach, Stacey Buxton, David Thwaites, Matthew Foote
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    Open Life Sciences.2020; 15(1): 389.     CrossRef
  • 9,830 View
  • 235 Download
  • 3 Web of Science
  • 3 Crossref
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Minimally Invasive Stereotactical Radio-ablation of Adrenal Metastases as an Alternative to Surgery
Ciro Franzese, Davide Franceschini, Luca Cozzi, Giuseppe D’Agostino, Tiziana Comito, Fiorenza De Rose, Pierina Navarria, Pietro Mancosu, Stefano Tomatis, Antonella Fogliata, Marta Scorsetti
Cancer Res Treat. 2017;49(1):20-28.   Published online April 27, 2016
DOI: https://doi.org/10.4143/crt.2016.057
AbstractAbstract PDFPubReaderePub
Purpose
The purpose of this study was to study the clinical outcome for patients with metastases of the adrenal gland treated with stereotactic body radiation therapy.
Materials and Methods
Forty-six patients were studied retrospectively. The dose prescription was 40 Gy in four fractions. Dosimetric analysis was performed using the dose volume histograms while clinical outcome was assessed using actuarial analysis with determination of the overall survival (OS) and local control (LC) rates.
Results
The planning objectives were met for all patients. With a median follow-up period of 7.6 months, at the last follow-up 42 patients (91.3%) were alive and four had died because of distant progression. The actuarial mean OS was 28.5±1.6 months, the median was not reached. One-year and 2-year OS were 87.6±6.1%. None of the risk factors was significant in univariate analysis. Actuarial mean LC was 14.6±1.8 months (95% confidence interval [CI], 11.0 to 18.2) and median LC was 14.5±2.0 months (95% CI, 10.5 to 18.5). One-year and 2-year LC were 65.5±11.9% and 40.7±15.8%, respectively. A mild profile of toxicity was observed in the cohort of patients. Forty patients (86.9%) showed no complication (grade 0); two patients reported asthenia, six patients (13.1%) reported either pain, nausea, or vomiting. Of these six patients, five patients (10.9%) were scored as grade 1 toxicity while one patient (2.2%) was scored as grade 2.
Conclusion
Stereotactic body radiation therapy treatment provided an adequate clinical response in the management of adrenal gland metastases.

Citations

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Review Article
The Role of Stereotactic Ablative Radiotherapy for Early-Stage and Oligometastatic Non-small Cell Lung Cancer: Evidence for Changing Paradigms
Max Dahele, Suresh Senan
Cancer Res Treat. 2011;43(2):75-82.   Published online June 30, 2011
DOI: https://doi.org/10.4143/crt.2011.43.2.75
AbstractAbstract PDFPubReaderePub
A compelling body of non-randomized evidence has established stereotactic ablative lung radiotherapy (SABR) as a standard of care for medically inoperable patients with peripheral early-stage non-small cell lung cancer (NSCLC). This convenient outpatient therapy, which is typically delivered in 3-8 fractions, is also well tolerated by elderly and frail patients, makes efficient use of resources and is feasible using standard commercial equipment. The introduction of lung SABR into large populations has led to an increased utilization of radiotherapy, a reduction in the proportion of untreated patients and an increase in overall survival. In selected patients, the same ablative technology can now achieve durable local control of NSCLC metastases in a variety of common locations including the adrenal glands, bone, brain, and liver. At the same time as this, advances in prognostic molecular markers and targeted systemic therapies mean that there is now a subgroup of patients with stage IV NSCLC and a median survival of around 2 years. This creates opportunities for new trials that incorporate SABR and patient-specific systemic strategies. This selective mini-review focuses on the emerging role of SABR in patients with early-stage and oligometastatic NSCLC.

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