A review of radiation genomics: integrating patient radiation response with genomics for personalised and targeted radiation therapy

2018 ◽  
Vol 18 (02) ◽  
pp. 198-209 ◽  
Author(s):  
Lu Xu ◽  
Beverley Osei ◽  
Ernest Osei
Keyword(s):  
Quality Of Life ◽  
Radiation Therapy ◽  
Radiation Dose ◽  
Adverse Effects ◽  
Treatment Response ◽  
Cancer Patients ◽  
Genetic Variants ◽  
Radiation Treatment ◽  
Genomic Data

AbstractBackgroundThe success of radiation therapy for cancer patients is dependent on the ability to deliver a total tumouricidal radiation dose capable of eradicating all cancer cells within the clinical target volume, however, the radiation dose tolerance of the surrounding healthy tissues becomes the main dose-limiting factor. The normal tissue adverse effects following radiotherapy are common and significantly impact the quality of life of patients. The likelihood of developing these adverse effects following radiotherapy cannot be predicted based only on the radiation treatment parameters. However, there is evidence to suggest that some common genetic variants are associated with radiotherapy response and the risk of developing adverse effects. Radiation genomics is a field that has evolved in recent years investigating the association between patient genomic data and the response to radiation therapy. This field aims to identify genetic markers that are linked to individual radiosensitivity with the potential to predict the risk of developing adverse effects due to radiotherapy using patient genomic information. It also aims to determine the relative radioresponse of patients using their genetic information for the potential prediction of patient radiation treatment response.Methods and materialsThis paper reports on a review of recent studies in the field of radiation genomics investigating the association between genomic data and patients response to radiation therapy, including the investigation of the role of genetic variants on an individual’s predisposition to enhanced radiotherapy radiosensitivity or radioresponse.ConclusionThe potential for early prediction of treatment response and patient outcome is critical in cancer patients to make decisions regarding continuation, escalation, discontinuation, and/or change in treatment options to maximise patient survival while minimising adverse effects and maintaining patients’ quality of life.

Randomized Trial of Antioxidant Vitamins to Prevent Acute Adverse Effects of Radiation Therapy in Head and Neck Cancer Patients

2005 ◽  
Vol 23 (24) ◽  
pp. 5805-5813 ◽  
Author(s):  
Isabelle Bairati ◽  
François Meyer ◽  
Michel Gélinas ◽  
André Fortin ◽  
Abdenour Nabid ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Radiation Therapy ◽  
Adverse Effects ◽  
Head And Neck ◽  
Cancer Patients ◽  
Treatment Efficacy ◽  
High Doses ◽  
Effects Of Radiation ◽  
Β Carotene

Purpose Many cancer patients take antioxidant vitamin supplements with the hope of improving the outcome of conventional therapies and of reducing the adverse effects of these treatments. A randomized trial was conducted to determine whether supplementation with antioxidant vitamins could reduce the occurrence and severity of acute adverse effects of radiation therapy and improve quality of life without compromising treatment efficacy. Patients and Methods We conducted a randomized, double-blind, placebo-controlled trial among 540 head and neck cancer patients treated with radiation therapy. Patients were randomly assigned into two arms. The supplementation with α-tocopherol (400 IU/d) and β-carotene (30 mg/d) or placebos was administered during radiation therapy and for 3 years thereafter. During the course of the trial, supplementation with β-carotene was discontinued because of ethical concerns. Results Patients randomly assigned in the supplement arm tended to have less severe acute adverse effects during radiation therapy (odds ratio [OR], 0.72; 95% CI, 0.52 to 1.02). The reduction was statistically significant when the supplementation combined α-tocopherol and β-carotene for adverse effects to the larynx (OR, 0.38; 95% CI, 0.21 to 0.71) and overall at any site (OR, 0.38; 95% CI, 0.20 to 0.74). Quality of life was not improved by the supplementation. The rate of local recurrence of the head and neck tumor tended to be higher in the supplement arm of the trial (hazard ratio, 1.37; 95% CI, 0.93 to 2.02). Conclusion Supplementation with high doses of α-tocopherol and β-carotene during radiation therapy could reduce the severity of treatment adverse effects. However, this trial suggests that use of high doses of antioxidants as adjuvant therapy might compromise radiation treatment efficacy.

scholarly journals Prevention and correction of radiation dermatitis with basic skin care: doctor and patient consensus

2021 ◽  
pp. 167-172
Author(s):  
D. A. Khlanta ◽  
D. S. Romanov
Keyword(s):  
Quality Of Life ◽  
Radiation Therapy ◽  
Radiation Treatment ◽  
Negative Impact ◽  
Clinical Manifestations ◽  
External Beam Radiation ◽  
Radiation Dermatitis ◽  
Beam Radiation ◽  
Post Radiation

External beam radiation therapy is widely used by doctors around the world as one of the most common form of cancer treatment. The radiotherapy can help reduce the treatment aggression as compared with the surgical intervention in a large number of clinical situations, which ensures that the patient's quality of life will be decreased to a lesser extent in the after-treatment period. However, like the vast majority of anticancer treatments, the radiation therapy has a number of side effects, which are classified into acute radiation reactions and post-radiation injuries. Among them is radiation dermatitis, which is one of the most common adverse reactions to the radiotherapy. This complication manifests as erythema, as well as hyperpigmentation, dry and itchy skin, hair loss. In addition to the obvious negative impact on the patient's quality of life, some of the above factors can result in the development of a secondary skin infection. As one of the most frequent post-radiation complications, radiation dermatitis places radiotherapists before a challenge to reduce the incidence rates of this side effect, as well as to decrease the intensity of its clinical manifestations if it occurs. This challenge suggests the search for targeted drugs aimed to prevent and treat clinical symptoms. To date, dermatocosmetic products that are used to relieve skin manifestations of radiation treatment complications is an alternate option of the effective solution to the problem of radiation dermatitis. In the described clinical case, we assess the experience of using some of the dermatocosmetic products in a patient with a florid form of radiation dermatitis. 

scholarly journals Predictive factors of posttreatment fracture by definitive radiotherapy for uterine cervical cancer

2020 ◽  
Author(s):  
Kazuki Ishikawa ◽  
Tsuneo Yamashiro ◽  
Takuro Ariga ◽  
Takafumi Toita ◽  
Wataru Kudaka ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Risk Factors ◽  
Cervical Cancer ◽  
Multivariate Analysis ◽  
Radiation Therapy ◽  
Cancer Patients ◽  
Clinical Characteristics ◽  
Univariate Analysis ◽  
Uterine Cervical Cancer

Abstract Purpose Fractures are known to shorten life expectancy and worsen the quality of life. The risk of fractures after radiation therapy in cervical cancer patients is known to be multifactorial. In this study, we examined risk factors for fractures in cervical cancer patients, especially by evaluating bone densities and DVH parameters for fractured bones. Materials and Methods For 42 patients, clinical characteristics, pretreatment CT bone densities, and radiation dose were compared between patients with and without fractures. Results Posttreatment fractures occurred in 25 bones among ten patients. Pretreatment CT bone densities were significantly lower in patients with fractures (P < 0.05–0.01 across sites, except for the ilium and the ischium). Although DVH parameters were also significantly associated with fractures in univariate analysis, only CT densities were significantly associated with fractures in multivariate analysis. Conclusion Pretreatment CT densities of spinal and pelvic bones, which may reflect osteoporosis, have a significant impact on the risk for posttreatment fractures.

Amitriptyline in Neuropathic Cancer Pain in Patients on Morphine Therapy: A Randomized Placebo-controlled, Double-blind Crossover Study

2002 ◽  
Vol 88 (3) ◽  
pp. 239-242 ◽  
Author(s):  
Sebastiano Mercadante ◽  
Edoardo Arcuri ◽  
Walter Tirelli ◽  
Patrizia Villari ◽  
Alessandra Casuccio
Keyword(s):  
Quality Of Life ◽  
Neuropathic Pain ◽  
Adverse Effects ◽  
Cancer Pain ◽  
Pain Intensity ◽  
Cancer Patients ◽  
Double Blind ◽  
Blind Crossover Study ◽  
Double Blind Crossover Study

Aims and Background Amitriptyline is the most common analgesic adjuvant used in cancer patients with neuropathic pain, even though no specific studies have demonstrated a benefit. A randomized placebo-controlled, double-blind crossover study was designed to evidence the effects of amitriptyline in patients with neuropathic cancer pain. Methods Sixteen advanced cancer patients with neuropathic pain on systemic morphine therapy, no longer receiving oncologic treatment, presenting moderate pain (about 4 or more, but less than 7, on a numerical scale of 0-10) in the last week, and given a stable morphine dose in the last 2 days were admitted to the study. During the first week of study, patients were administered 25 mg of amitriptyline or equivalent drops of placebo at night for 3 days and 50 mg for the following 4 days. Doses for patients aged more than 65 years were 15 mg (first 3 days) and 30 mg (3 days after). After a week, a crossover took place for the second week, with the other treatment at an inverse sequence. Opioid consumption, pain intensity, symptoms and adverse effects, mood, sleep, patient's preference, quality of life before starting the study, the first week after and the second week after were recorded. Results No significant benefits in analgesia were found in the global pain intensity of the previous week of treatment, the least pain intensity or the pain evaluated just after a week of treatment, at the moment of the visit, when amitriptyline was compared with placebo. A significant difference was evidenced for the worst pain (P < 0.035). No differences in opioid doses during the period of study were found. Drowsiness, confusion and dry mouth were significantly more intense with amitriptyline than with placebo (P < 0.036, 0.003, and 0.034, respectively). There were no substantial differences between the two treatments in Spitzer's quality of life score and for each item. No differences in patients' preference for the two treatment periods were found. The analgesic effects of amitriptyline were slight and associated with adverse effects. Conclusions In light of the results obtained in the study, the extensive use of the drug for cancer pain should be questioned.

scholarly journals Five-year quality of life of endometrial cancer patients treated in the randomised Post Operative Radiation Therapy in Endometrial Cancer (PORTEC-2) trial and comparison with norm data

2012 ◽  
Vol 48 (11) ◽  
pp. 1638-1648 ◽  
Author(s):  
Remi A. Nout ◽  
Hein Putter ◽  
Ina M. Jürgenliemk-Schulz ◽  
Jan J. Jobsen ◽  
Ludy C.H.W. Lutgens ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Radiation Therapy ◽  
Endometrial Cancer ◽  
Cancer Patients

Reversal of anorexia with megestrol acetate (MA): Impact on quality of life (QoL) in non-metastasic lung cancer patients (pts) undergoing radiation therapy

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 18613-18613 ◽  
Author(s):  
J. Pardo ◽  
A. Mena ◽  
A. Monleon ◽  
V. Macias ◽  
J. Sole ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Lung Cancer ◽  
Radiation Therapy ◽  
Cancer Patients ◽  
Life Questionnaire ◽  
Negative Effects ◽  
Lung Cancer Patients ◽  
Related Quality ◽  
The Difference

18613 Background: Anorexia is a common and major problem in cancer patients. Its ethiology is multifactorial and has negative effects on pts QoL. Up to 30% of non-metastasic lung cancer pts receiving radiotherapy will develop anorexia during treatment. We conducted a randomized trial comparing the efficacy of two different doses of MA. The results of the first 130 pts included, presented at ASCO 2003, indicated that MA at doses of 600 mg/day is significantly more effective in the treatment of anorexia in these pts than low doses (320 mg/day) of MA. Here we present the results of the quality of life sub-study which purpose is to evaluate the effect of reversing anorexia in pts health related quality of life (HRQOL). Methods: From February 1999 to April 2003, 160 non-mestastatic lung cancer pts who developed anorexia during radiotherapy were randomized to receive either 320 mg/day or 600 mg/day of MA. All pts who developed anorexia filled up the EuroQuol (EQ-5D) quality of life questionnaire before treated with MA and the responders did it again when appetite was regained. The endpoint was improvement in pts HRQOL (defined as an increase > 5 mm in the EQVAS score between the second and first questionnaires). Results: The analysis of the EuroQuol (EQ-5D) questionnaires of the 131 pts who responded to treatment with MA shows that 106 pts (81%) had an improvement > 5 mm in the EQVAS score while 19 % did not. The difference is statistically significant (Binomial test: p < 0.0001). Regarding differences between the two series, 42 pts improved in the 320 mg arm versus 64 in the 600 mg arm which is not statistically significant (Fisher test: p = 0.501). Conclusions: Our results indicate that reversal of anorexia with MA has a clinically significant improvement in HRQOL in non-metastatic lung cancer pts undergoing radiation therapy. The absence of statistically significant differences between the two series may be due to the sample size. [Table: see text] No significant financial relationships to disclose.

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