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The Role of Stereotactic Ablative Radiotherapy in the Management of...
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The Role of Stereotactic Ablative Radiotherapy in the Management of Localized and Metastatic Genitourinary Tumours

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

Deadline for manuscript submissions: 29 June 2024 | Viewed by 3619

Special Issue Editors

Dr. Stefano Arcangeli

E-Mail Website
Guest Editor
Department of Radiation Oncology, San Gerardo Hospital, 20900 Monza, Italy
Interests: radiotherapy
Dr. Giulia Marvaso

E-Mail Website
Guest Editor
Department of Radiotherapy, European Institute of Oncology (IEO) IRCCS, 20141 Milan, Italy
Interests: urological malignancies; radiation oncology; new fractionation protocols; treatment accuracy; patient’s quality of life; prognostic and predictive factors; SBRT hypofractionation; oligometastatic disease
Special Issues, Collections and Topics in MDPI journals
Dr. Denis Panizza

E-Mail Website
Guest Editor
Department of Medical Physics, San Gerardo Hospital, Monza, Italy
Interests: radiotherapy

Special Issue Information

Dear Colleagues, 

The development of stereotactic body radiotherapy (SBRT), building on its intrinsic physical properties, restriction of tumour movement during treatment (tumour motion management) and meticulous verification of tumour position before and during treatment (image-guided radiation therapy (IGRT)), now allows for the delivery of ablative doses of radiation to both primary and metastatic tumours with high control rates and minimal toxicity.

Accumulating evidence shows that SBRT is an attractive approach to reduce the burden of care without losing clinical effectiveness, and is entitled to become the procedure of choice for the management of many patients with primary and/or oligometastatic GU malignancies, especially in light of the increasing number of elderly patients in need of treatment. Furthermore, the success of SBRT, relying on its ability to deliver high radiation doses to the target and yet sparing the surrounding normal tissues, seems to be confirmed in radioresistant histologies (i.e., renal tumours, sarcomas), thus defying the principles of the established radiobiological paradigm. An in-depth analysis of several aspects underlying the role of SBRT in this setting, as well as its potential interaction with the newest systemic therapies, will aid in the development of new therapeutic strategies in these  common and often undertreated diseases.

Dr. Stefano Arcangeli
Dr. Giulia Marvaso
Dr. Denis Panizza
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com 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

  • stereotactic body radiation therapy (SBRT)
  • image-guided radiation therapy (IGRT)
  • imaging
  • prostate cancer
  • kidney cancer
  • motion management
  • oligometastases
  • androgen deprivation therapy (ADT)
  • targeted therapy
  • immunotherapy
  • toxicity

Published Papers (2 papers)

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Research

11 pages, 4427 KiB  
Article
Treatment Optimization in Linac-Based SBRT for Localized Prostate Cancer: A Single-Arc versus Dual-Arc Plan Comparison
by Denis Panizza, Valeria Faccenda, Stefano Arcangeli and Elena De Ponti
Cancers 2024, 16(1), 13; https://doi.org/10.3390/cancers16010013 (registering DOI) - 19 Dec 2023
Viewed by 2249
Abstract
This study aimed to comprehensively present data on treatment optimization in linac-based SBRT for localized prostate cancer at a single institution. Moreover, the dosimetric quality and treatment efficiency of single-arc (SA) versus dual-arc (DA) VMAT planning and delivery approaches were compared. Re-optimization was [...] Read more.
This study aimed to comprehensively present data on treatment optimization in linac-based SBRT for localized prostate cancer at a single institution. Moreover, the dosimetric quality and treatment efficiency of single-arc (SA) versus dual-arc (DA) VMAT planning and delivery approaches were compared. Re-optimization was performed on twenty low-to-intermediate-risk- (36.25 Gy in 5 fractions) and twenty high-risk (42.7 Gy in 7 fractions) prostate plans initially administered with the DA FFF-VMAT technique in 2021. An SA approach was adopted, incorporating new optimization parameters based on increased planning and clinical experience. Analysis included target coverage, organ-at-risk (OAR) sparing, treatment delivery time, and the pre-treatment verification’s gamma analysis-passing ratio. The SA optimization technique has consistently produced superior plans. Rectum and bladder mean doses were significantly reduced, and comparable target coverage and homogeneity were achieved in order to maintain a urethra protection strategy. The mean SA treatment delivery time was reduced by 22%; the mean monitor units increased due to higher plan complexity; and dose measurements demonstrated optimal agreement with calculations. The substantial reduction in treatment delivery time decreased the probability of prostate motion beyond the applied margins, suggesting potential decrease in treatment-related toxicity and improved target coverage in prostate SBRT. Further investigations are warranted to assess the long-term clinical outcomes. Full article
(This article belongs to the Special Issue The Role of Stereotactic Ablative Radiotherapy in the Management of Localized and Metastatic Genitourinary Tumours)
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10 pages, 647 KiB  
Article
Five Fractions versus Seven Fractions SBRT for Intermediate- and High-Risk Prostate Cancer: A Propensity Score Matched Pair Analysis
by Christina Schröder, Lucas Mose, Etienne Mathier, Daniel Rudolf Zwahlen, Daniel Matthias Aebersold, Robert Förster and Mohamed Shelan
Cancers 2023, 15(24), 5815; https://doi.org/10.3390/cancers15245815 (registering DOI) - 12 Dec 2023
Viewed by 905
Abstract
Purpose: To compare two stereotactic body radiotherapy (SBRT) regimens in patients with intermediate- or high-risk prostate cancer with regards toxicity and efficacy. Methods/Material: We retrospectively collected data from 198 patients treated with SBRT for prostate cancer at two different institutions. Patients received either [...] Read more.
Purpose: To compare two stereotactic body radiotherapy (SBRT) regimens in patients with intermediate- or high-risk prostate cancer with regards toxicity and efficacy. Methods/Material: We retrospectively collected data from 198 patients treated with SBRT for prostate cancer at two different institutions. Patients received either 35–36.25 Gy in five fractions (group A) using Cyberknife robotic platform or 42.7 Gy in seven fractions (group B) using a C-arm LINAC (image-guided). Propensity score matching was done (2:1 nearest neighbor matching without replacement), resulting in 120 patients (80 patients for group A, 40 patients for group B). Toxicity, PSA nadir, biochemical failure and disease-free survival (DFS) were analyzed. Results: Median follow up of all patients was 13 months (range 1–91 months). Overall, 23.3% of patients had ≥G2 acute GU toxicity (21.1% group A versus 30% group B (p = 0.222)) and 6.6% of patients ≥G2 GI toxicity (2.5% versus 15% (p = 0.010)). There was one acute G3 GU toxicity in arm A and one acute G4 rectal bleeding in group B (anticoagulated patient). Regarding late toxicity, 14.1% of patients had ≥G2 late GU toxicity (17.4% versus 6.6% (p = 0.159)) and 5.0% of patients had ≥G2 late GI toxicity (1.4% versus 13.3% (p = 0.013)). There was one G3 late GU toxicity in arm B and two G3 late GI toxicities, one in each arm. Relative median PSA reduction was 92.4% (−53.9–99.9%) from baseline PSA (93.7% (−53.9–99.9%) in group A versus 87.7% (39.8–99.9%) in group B (p = 0.043). In total, 4.2% of patients had biochemical relapse, 5.0% in group A and 2.5% in group B (p = 0.518). One-year DFS in the overall cohort was 97.3%, 98.8% in group A and 94.3% in group B (p = 0.318). Conclusion: Both SBRT regimens have acceptable acute and late toxicity and good efficacy. There are significantly more GI toxicities in the seven-fraction regimen. Longer follow-up is warranted for better comparison of long-term efficacy. Full article
(This article belongs to the Special Issue The Role of Stereotactic Ablative Radiotherapy in the Management of Localized and Metastatic Genitourinary Tumours)
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