open access

Vol 67, No 5 (2017)
Irradiation techniques
Published online: 2018-02-22
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Bone marrow sparing RT in era of immunotherapy

Łukasz Kuncman, Malwina Pietrzykowska-Kuncman, Justyna Danielska, Jolanta Łuniewska-Bury, Jacek Fijuth
DOI: 10.5603/NJO.2017.0050
·
Nowotwory. Journal of Oncology 2017;67(5):301-307.

open access

Vol 67, No 5 (2017)
Irradiation techniques
Published online: 2018-02-22

Abstract

Recent advances in the field of immunotherapy have changed the perception of cancer treatment to complex model with host immunity in the spotlight. Potential synergy of immunotherapy drugs [aiming cytotoxic T cell antigen 4 (CTLA-4) or programmed cell death-1/ligand (PD-1/PD-L1)] and radiotherapy (RT) have established basis for ongo­ing clinical trials testing combined treatment. It was shown that complete blood cell counts (CBC) parameters may correlate with cancer survival, toxicity and outcomes of treatment. Therefore, reduction of hematologic toxicity of cancer treatment may gain in significance. Modern dose delivery techniques compromise dose reduction in critical organs (like bone marrow — BM) with adequate irradiation of target volumes. In addition, usage of modern imaging like positron emission tomography (PET), magnetic resonance imaging (MRI) allows to divide the volume of BM to active and inactive one.

In this review, we discuss the synergy of RT and immunity and techniques of Bone Marrow Sparing RT (BMS-RT).

Abstract

Recent advances in the field of immunotherapy have changed the perception of cancer treatment to complex model with host immunity in the spotlight. Potential synergy of immunotherapy drugs [aiming cytotoxic T cell antigen 4 (CTLA-4) or programmed cell death-1/ligand (PD-1/PD-L1)] and radiotherapy (RT) have established basis for ongo­ing clinical trials testing combined treatment. It was shown that complete blood cell counts (CBC) parameters may correlate with cancer survival, toxicity and outcomes of treatment. Therefore, reduction of hematologic toxicity of cancer treatment may gain in significance. Modern dose delivery techniques compromise dose reduction in critical organs (like bone marrow — BM) with adequate irradiation of target volumes. In addition, usage of modern imaging like positron emission tomography (PET), magnetic resonance imaging (MRI) allows to divide the volume of BM to active and inactive one.

In this review, we discuss the synergy of RT and immunity and techniques of Bone Marrow Sparing RT (BMS-RT).

Get Citation

Keywords

radiotherapy, intensity-modulated radiotherapy, bone marrow, red bone marrow, yellow bone marrow, immunotherapy, lymphopenia, neutropenia, thrombocytopenia, anaemia

About this article
Title

Bone marrow sparing RT in era of immunotherapy

Journal

Nowotwory. Journal of Oncology

Issue

Vol 67, No 5 (2017)

Pages

301-307

Published online

2018-02-22

DOI

10.5603/NJO.2017.0050

Bibliographic record

Nowotwory. Journal of Oncology 2017;67(5):301-307.

Keywords

radiotherapy
intensity-modulated radiotherapy
bone marrow
red bone marrow
yellow bone marrow
immunotherapy
lymphopenia
neutropenia
thrombocytopenia
anaemia

Authors

Łukasz Kuncman
Malwina Pietrzykowska-Kuncman
Justyna Danielska
Jolanta Łuniewska-Bury
Jacek Fijuth

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