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radiotherapy

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Radiotherapy

Radiation therapy, radiotherapy, or radiation oncology, often abbreviated RT, RTx, or XRT, is the medical use of ionizing radiation, generally as part of cancer treatment to control or kill malignant cells. Radiation therapy may be curative in a number of types of cancer if they are localized to one area of the body. It may also be used as part of adjuvant therapy, to prevent tumor recurrence after surgery to remove a primary malignant tumor (for example, early stages of breast cancer). Radiation therapy is synergistic with chemotherapy, and has been used before, during, and after chemotherapy in susceptible cancers.

Types

Indications

The last major advance in glioblastoma multiforme treatment was the introduction of temozolomide in 1999.

Concomitant radiotherapy + temozolamide is more effective and improves the overall survival and progression free survival in patients with newly diagnosed glioblastoma.


Steroids are very commonly administered concurrently with temozolomide and radiotherapy after the initial surgical resection of glioblastoma (GBM) to control neurological morbidity. Although the potent anti-inflammatory effect of steroids is well documented to ameliorate vasogenic edema in these tumors, the deleterious effects of steroids on the efficacy of alkylating agents or radiotherapy have been a matter of debate 1) 2) 3) 4).

1)
Piette C, Munaut C, Foidart JM, Deprez M. Treating gliomas with glucocorticoids: from bedside to bench. Acta Neuropathol. 2006;112(6):651–664.
2)
Wang H, Li M, Rinehart JJ, Zhang R. Pretreatment with dexamethasone increases antitumor activity of carboplatin and gemcitabine in mice bearing human cancer xenografts: in vivo activity, pharmacokinetics, and clinical implications for cancer chemotherapy. Clin Cancer Res. 2004;10(5):1633–1644.
3)
Weller M, Schmidt C, Roth W, Dichgans J. Chemotherapy of human malignant glioma: prevention of efficacy by dexamethasone? Neurology. 1997;48(6):1704–1709.
4)
Shields LB, Shelton BJ, Shearer AJ, et al. Dexamethasone administration during definitive radiation and temozolomide renders a poor prognosis in a retrospective analysis of newly diagnosed glioblastoma patients. Radiat Oncol. 2015;10:222.
radiotherapy.txt · Last modified: 2017/08/10 19:20 by administrador