{"slug":"radiation","tag":"radiation","variants":["radiation"],"description":"No description yet","count":15,"kinds":{"technology":1,"term":2,"paper":11,"company":1},"related":[{"slug":"precision","tag":"precision","shared":13},{"slug":"fertility","tag":"fertility","shared":1},{"slug":"late-effects","tag":"late-effects","shared":1},{"slug":"radiation-wave3","tag":"radiation-wave3","shared":1},{"slug":"rejuvenation","tag":"rejuvenation","shared":1},{"slug":"survivorship","tag":"survivorship","shared":1},{"slug":"transplant","tag":"transplant","shared":1}],"records":[{"id":"rejuv-tx-fertility-and-growth","kind":"technology","name":"Fertility, growth and what total body irradiation costs","route":"/technologies/rejuv-tx-fertility-and-growth/","status":"established","tldr":"Transplant conditioning, and total body irradiation in particular, usually ends natural fertility and in children slows growth. The decisions that preserve the most are made before conditioning starts. A randomised trial in children with leukaemia tested replacing the radiation with chemotherapy and found the radiation worked better."},{"id":"proton-range-uncertainty","kind":"term","name":"Proton range uncertainty and the range margin","route":"/terms/proton-range-uncertainty/","tldr":"A proton beam stops at a depth that cannot be predicted exactly, so planners deliberately aim it a few millimetres past the tumour. At one leading centre the allowance is 3.5 per cent of the beam's range plus 1 millimetre, which for a beam reaching 20 centimetres into soft tissue means overshooting by about 8 millimetres."},{"id":"target-delineation-variability","kind":"term","name":"Variation between clinicians in drawing the radiotherapy target","route":"/terms/target-delineation-variability/","tldr":"Before a radiotherapy plan can be made, a doctor draws the tumour and the organs around it on the planning scan, and two doctors given the same scan do not draw the same outline. A 2016 review found 119 studies measuring this across every major cancer site, and only one in five checked what the differences did to the dose."},{"id":"paper-van-herk-ptv-margin-recipe-ijrobp-2000","kind":"paper","name":"The probability of correct target dosage: dose-population histograms for deriving treatment margins in radiotherapy","route":"/key-papers/paper-van-herk-ptv-margin-recipe-ijrobp-2000/","tldr":"The paper behind the margin most radiotherapy departments add around a target. It showed that errors repeated every day matter far more than errors that vary day to day, and turned that into a formula: a margin of 2.5 times the systematic error plus 0.7 times the random error."},{"id":"paper-vinod-delineation-uncertainty-review-radiother-oncol-2016","kind":"paper","name":"Uncertainties in volume delineation in radiation oncology: a systematic review and recommendations for future studies","route":"/key-papers/paper-vinod-delineation-uncertainty-review-radiother-oncol-2016/","tldr":"A review of 119 studies in which several clinicians drew the same radiotherapy targets. The studies measured the disagreement in so many different ways that they could not be combined, and only 21 per cent checked what it did to the dose."},{"id":"paper-kirkpatrick-srs-margin-trial-ijrobp-2015","kind":"paper","name":"Defining the optimal planning target volume in image-guided stereotactic radiosurgery of brain metastases: results of a randomized trial","route":"/key-papers/paper-kirkpatrick-srs-margin-trial-ijrobp-2015/","tldr":"Brain metastases treated with radiosurgery were randomly given a 1 millimetre or a 3 millimetre margin. Control of the treated tumours was similar, the larger margin irradiated more healthy brain, and five of the six biopsy-proven cases of radiation damage were in the 3 millimetre group."},{"id":"paper-de-crevoisier-daily-weekly-igrt-ijrobp-2018","kind":"paper","name":"Daily versus weekly prostate cancer image guided radiation therapy: phase 3 multicenter randomized trial","route":"/key-papers/paper-de-crevoisier-daily-weekly-igrt-ijrobp-2018/","tldr":"A French trial of 470 men compared checking the prostate's position with imaging before every radiotherapy session against checking weekly. Daily imaging lowered rectal side effects and PSA-defined progression, but the main endpoint, recurrence-free survival, did not differ, and overall survival was worse in the daily group."},{"id":"paper-flame-focal-boost-prostate-jco-2021","kind":"paper","name":"Focal boost to the intraprostatic tumor in external beam radiotherapy for patients with localized prostate cancer: results from the FLAME randomized phase III trial","route":"/key-papers/paper-flame-focal-boost-prostate-jco-2021/","tldr":"A trial of 571 men with intermediate or high-risk prostate cancer gave half of them an extra dose, up to 95 Gy, to the tumour visible on MRI inside the prostate. After five years 92 per cent of the boosted group were free of PSA relapse against 85 per cent, with no measurable increase in side effects and no difference in survival."},{"id":"paper-liao-proton-vs-imrt-nsclc-jco-2018","kind":"paper","name":"Bayesian adaptive randomization trial of passive scattering proton therapy and intensity-modulated photon radiotherapy for locally advanced non-small-cell lung cancer","route":"/key-papers/paper-liao-proton-vs-imrt-nsclc-jco-2018/","tldr":"The first randomised comparison of protons with modern photon radiotherapy for lung cancer. Protons spared the heart but not the lung overall, and neither severe lung inflammation nor local failure was reduced: 10.5 per cent against 6.5 per cent for lung inflammation, 10.5 against 10.9 per cent for local failure."},{"id":"paper-paganetti-range-uncertainties-pmb-2012","kind":"paper","name":"Range uncertainties in proton therapy and the role of Monte Carlo simulations","route":"/key-papers/paper-paganetti-range-uncertainties-pmb-2012/","tldr":"A review of why the depth at which a proton beam stops cannot be predicted exactly, and how much margin centres add for it. One common recipe, 3.5 per cent of the range plus 1 millimetre, overshoots by about 8 millimetres for a beam reaching 20 centimetres into soft tissue."},{"id":"paper-heartspare-stage-ii-clin-oncol-2017","kind":"paper","name":"The UK HeartSpare Study (Stage II): multicentre evaluation of a voluntary breath-hold technique in patients receiving breast radiotherapy","route":"/key-papers/paper-heartspare-stage-ii-clin-oncol-2017/","tldr":"In ten UK centres, women having radiotherapy for left breast cancer were taught to hold a deep breath during treatment without any machine to help. Ninety-five per cent had a lower heart dose as a result, and the average heart dose fell from 1.8 to 1.1 Gy."},{"id":"paper-smyth-dibh-cardiac-sparing-review-jmrs-2015","kind":"paper","name":"The cardiac dose-sparing benefits of deep inspiration breath-hold in left breast irradiation: a systematic review","route":"/key-papers/paper-smyth-dibh-cardiac-sparing-review-jmrs-2015/","tldr":"A review of ten studies comparing radiotherapy plans for left breast cancer made in deep breath-hold and in free breathing. Breath-hold cut the average heart dose by up to 3.4 Gy, which on published dose-risk estimates corresponds to a 13.6 per cent smaller projected rise in heart disease risk."},{"id":"paper-favaudon-flash-mice-sci-transl-med-2014","kind":"paper","name":"Ultrahigh dose-rate FLASH irradiation increases the differential response between normal and tumor tissue in mice","route":"/key-papers/paper-favaudon-flash-mice-sci-transl-med-2014/","tldr":"The mouse study that started modern FLASH research. Radiation given in a fraction of a second spared the lungs of mice from scarring at doses that scarred them when given at the usual rate, while controlling tumours just as well. It was in mice, and the effect in people has not been shown."},{"id":"paper-open-trial-open-face-masks-sgrt-radiother-oncol-2026","kind":"paper","name":"OPEN: optimising patient experience in head and neck radiotherapy, a phase 3 randomised control trial comparing open versus closed face masks","route":"/key-papers/paper-open-trial-open-face-masks-sgrt-radiother-oncol-2026/","tldr":"People having radiotherapy for head and neck cancer were randomly given the standard closed face mask or one of two open masks, with cameras tracking the face during treatment. The open masks were set up as accurately and were significantly better tolerated."},{"id":"nanobiotix","kind":"company","name":"Nanobiotix","route":"/companies/nanobiotix/","tldr":"Nanobiotix is the Paris nanomedicine company behind NBTXR3, hafnium oxide nanoparticles injected into a tumour to make radiotherapy deposit more energy inside it."}]}