open access
Bone marrow sparing RT in era of immunotherapy
open access
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).
Keywords
radiotherapy, intensity-modulated radiotherapy, bone marrow, red bone marrow, yellow bone marrow, immunotherapy, lymphopenia, neutropenia, thrombocytopenia, anaemia
About this articleTitle
Bone marrow sparing RT in era of immunotherapy
Journal
Nowotwory. Journal of Oncology
Issue
Pages
301-307
Published online
2018-02-22
Page views
859
Article views/downloads
892
DOI
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