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Cancers
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Radiation Therapy for Modern Management of Bone Metastases
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Radiation Therapy for Modern Management of Bone Metastases

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Therapy".

Deadline for manuscript submissions: 30 November 2024 | Viewed by 1778

Special Issue Editor

Dr. Francesco Cellini

E-Mail Website
Guest Editor
Department of Diagnostic Imaging, Oncological Radiotherapy, and Hematology, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, 00168 Roma, Italy
Interests: gastrointestinal cancer; genitourinary tract cancer; technology advances in radiation oncology; MRI-guided-radiation oncology; lung cancer; breast cancer; precision radiotherapy

Special Issue Information

Dear Colleagues,

Bone metastases (BM) frequently occur during malignant disease. The incidence of BM is expected to rise in the future due to an increase in the survival rates of patients with cancer. Radiotherapy (RT) is a crucial part of the management of BM. RT can efficiently relieve pain and improve the quality of life of patients, thus forming a crucial part of palliative care in general. Moreover, recent insights suggest a clear effect on the improvement of the disease and overall survival by locally controlling single metastases, along with the administration of systemic therapies (thus including the ablative approach aiming for local control of BM) in oligometastatic settings. Finally, RT can play a role in improving the systemic effect of immune oncological therapy by the local treatment of lesions, including BM.

The clinical indications, the prescriptive optimal dose for each clinical sub-setting and different aim (e.g., palliation, local ablation and immune reaction stimulation), the target delineations and many other factors are still unclear, which makes investigating these issues an urgent challenge for modern oncologists and radiation oncologists in particular. Our Special Issue will deal these issues in this research field.

Dr. Francesco Cellini
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at mdpi.longhoe.net by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Cancers is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • radiotherapy
  • palliative care
  • steretactic radiotherapy
  • SBRT
  • immunotherapy
  • chemotherapy
  • oligometastases

Published Papers (2 papers)

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Research

11 pages, 642 KiB  
Article
Phase II Clinical Trial of Second Course of Stereotactic Body Radiotherapy for Spinal Metastases
by Kei Ito, Yujiro Nakajima, Kentaro Taguchi, Hiroaki Ogawa, Makoto Saito and Keiko Nemoto Murofushi
Cancers 2024, 16(12), 2286; https://doi.org/10.3390/cancers16122286 - 20 Jun 2024
Viewed by 381
Abstract
Purpose: The optimal method for the second course of stereotactic body radiotherapy (SBRT) for spinal metastases remains poorly established. This single-center, single-arm, phase II trial was conducted to propose a safe and effective salvage spine SBRT. Methods: The patients initially treated with SBRT [...] Read more.
Purpose: The optimal method for the second course of stereotactic body radiotherapy (SBRT) for spinal metastases remains poorly established. This single-center, single-arm, phase II trial was conducted to propose a safe and effective salvage spine SBRT. Methods: The patients initially treated with SBRT for spine-targeted protocol treatment, or for areas adjacent to the spine, were enrolled. The second SBRT dose was 30 Gy delivered in five fractions; the spinal cord dose constraint was 15.5 Gy at the maximum point dose. The brachial or lumbosacral plexuses were dose-constrained to <30 Gy if the boundary between the nerves and tumors was detected. The primary endpoint was dose-limiting toxicity (DLT) (grade ≥ 3 severe radiation-related toxicity) within a year after the second SBRT. Results: The second SBRT was administered to the same spinal level in 12 patients and to an adjacent spinal level in 8 patients. SBRT2 was performed for 14 painful lesions, 10 MESCC, and 6 oligometastases, with some lesions having multiple indications. The median interval between SBRT sessions was 21 months (range: 6–51 months). The median follow-up duration was 14 months. No radiation myelopathy or local failure was reported during the follow-up period. DLT was confirmed in two patients (10%) within a year, both of whom developed grade 3 lumbosacral plexopathy. These two patients received SBRT twice to the S1–2 and S1–5 vertebrae, respectively, and both experienced paralysis of the tibialis anterior muscle (L5 level). Grade 3 late adverse effects (including lumbosacral plexopathy and vertebral compression fracture) were observed in 25% of the patients throughout the entire follow-up period. Conclusions: The second spine SBRT achieved good local control without causing myelopathy. However, one-quarter of the patients experienced grade 3 late adverse effects, suggesting that the treatment protocol carries a risk of toxicity. Full article
(This article belongs to the Special Issue Radiation Therapy for Modern Management of Bone Metastases)
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15 pages, 7695 KiB  
Article
Treatment of Pelvic and Spinal Bone Metastases: Radiotherapy and Hyperthermia Alone vs. in Combination
by Jong-Hun Kim, **-Yong Shin and Sun-Young Lee
Cancers 2024, 16(8), 1604; https://doi.org/10.3390/cancers16081604 - 22 Apr 2024
Viewed by 859
Abstract
Painful pelvic and spinal bone metastases are a considerable challenge for doctors and patients. Conventional therapies include morphine-equivalent medication (MeM) and local radiotherapy (RT), but these interventions are not always successful. More recently, hyperthermia (HT) has been applied to complement RT and MeM, [...] Read more.
Painful pelvic and spinal bone metastases are a considerable challenge for doctors and patients. Conventional therapies include morphine-equivalent medication (MeM) and local radiotherapy (RT), but these interventions are not always successful. More recently, hyperthermia (HT) has been applied to complement RT and MeM, and this complex approach has shown promising synergistic results. The objective of our study was to present the results of RT combined with a special kind of HT (modulated electrohyperthermia, mEHT), in which some of the thermal effect is contributed by equivalent nonthermal components, drastically reducing the necessary power and energy. This retrospective study included 61 patients divided into three groups with pelvic and spinal bone metastases to compare the effects of RT and mEHT alone and in combination (RT + mEHT). A detailed evaluation of pain intensity, measured by the brief pain inventory score, MeM use, and breakthrough pain episodes, revealed no significant differences between RT and mEHT alone; thus, these individual methods were considered equivalent. However, RT + mEHT yielded significantly better results in terms of the above parameters. Clinically, mEHT has a lower risk of adverse thermal effects, and due to its efficacy, mEHT can be used to treat RT-resistant lesions. Full article
(This article belongs to the Special Issue Radiation Therapy for Modern Management of Bone Metastases)
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