Clinical Oncology

[Promising Radiotherapy techniques at the beginning of clinical implementation: microbeam- and FLASH therapy]

HIDEGHÉTY Katalin1,2, TŐKÉS Tünde1,2, POLANEK Róbert2, SZABÓ Emília Rita2

FEBRUARY 28, 2021

Clinical Oncology - 2021;8(1)

[Recent technical developments have enabled to implement ideas raised a few decades earlier. Extensive radiobiology experiments have demonstrated the potential clinical benefit from novel irradiation techniques with ultra high spatial and temporal resolution. A large number of preclinical studies have proven that instead of using homogeneous irradiation fields, arrays of tenths of millimeter beams spaced some hundred micrometer (microbeam radiotherapy – MRT) result in a significant increase in the therapeutical index. The similar radiobiological advantage could be achieved with high dose (>10 Gy) delivery, with extreme high dose rate (≥106 Gy/s), within maximal 500 ms (flash radiotherapy), promising better normal tissue protection but similar tumour treatment efficacy compared to conventional, continuous dose delivery over minutes. A century back the first type of spatial fractionation (SFRT) at cm level the GRID therapy was proposed, which was developed to a 3-dimensional format to the LATTICE irradiation providing significant clinical experiences. The highly promising renascent of SFRT at µm level (MRT) is just prior to clinical investigation. Meanwhile one year after a case of human flash irradiation, the first clinical trial launched in the USA in October 2020. In this review, we summarize the basics of the two emerging radiation modalities, MRT and flash irradiation, technical conditions, possible mechanisms of action, preclinical results to date, and potential clinical applications.]

AFFILIATIONS

  1. Szegedi Tudományegyetem, Onkoterápiás Klinika, Szeged
  2. ELI-HU Nonprofit Kft., Szeged

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[Hopefully, towards the end of the Covid-19 pandemic, we intend to provide a brief overview of the infection, the pathogen, most effective treatment options, lung damage, and the results of TERAVOLT clinical trial, about patients with lung cancer, treated or not-treated, infected by SARS-CoV-2 virus. Tried to summarize the new diagnostic and therapy rules (bronchoscopy, chest x-ray, chest CT), and the potential new vaccinations. Authors provide a brief overview of the treatment of respiratory and cancer patients during infection, the continuation of inhalation drugs, immunotherapy and/or chemotherapy.]

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[Treatment of cancer associated venous thromboembolism in the age of direct oral anticoagulants]

AY C, BEYER-WESTENDORF J, PABINGER I

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[(K)RAS mutant human cancers]

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