New books and Journal Articles of interest

New Books and Journal Articles of Interest to the Pediatric Radiation Oncologist

This section is managed by Professor Edward Halperin who will collect all information, comments on articles or thoughts you wish to send to him.

In this section you can talk about events which have made an impact on you, or which you feel it is important to share. These may concern scientific articles, congresses, thoughts on training for young people, the handling of tumours in children by health authorities.

It is also an opportunity to compare different practices throughout the world. Please send all ideas, suggestions and comments to Edward Halperin .

March 2022:

In this feature, which will appear periodically in the Pediatric Radiation Oncology (PROS) website, we will describe new books and journal articles that are likely to be of interest to the pediatric radiation oncology community. 

Yasmin-Karin S, et al. Boosting the abscopal effect using immunogenicity biomaterials with varying radiation therapy field sizes. Int J Rad Oncol Biol Phys 112:475-486, 2022.

This remarkably clever experiment studied the abscopal effect. Two syngenic contralateral tumors were implanted in each mouse. Only one tumor was irradiated. An immunogenic biomaterial was injected into one tumor in a form equivalent to the fiducial marker seeds we use in external beam radiotherapy. 

The immunogenic biomaterial impressively accentuated the effect of a single fraction of radiotherapy in both pancreatic and prostate cancers, heightened the abscopal effect, and induced proinflammatory cytokines. 

Deland K, et al. Radiosensitizing the vasculature of primary brainstem gliomas fails to improve tumor response to radiation therapy. Int J Rad Oncol Biol Phys 112:771-779, 2022.

RCAS stands for replication-competent avian sarcoma-leukosis virus long-terminal repeat with splice acceptor. The virus enters cells via the TVA receptor, which mammalian cells do not natively express. Following entry into a mammalian cell, a cDNA copy of the viral genome is made. When the cell undergoes division, the viral cDNA copy incorporates into the mammalian host genome. In order to evaluate the role of vascular damage in regulating pontine glioma response to radiation therapy, the authors used RCAS-TVA and dual recombinase technology to generate primary brainstem gliomas with radiosensitive vasculature in severe combined immunodeficiency mice. 

To enhance the death of endothelial cells the authors used transgenic mice with ATM deleted in endothelial cells. 

Radiation therapy killed endothelial cells with three times the efficacy and doubled the overall tumor cell death, but did not improve the survival of the mice.

Primary brainstem gliomas are notoriously recalcitrant to treatment. This sobering experiment suggests that enhancing endothelial cell death will be insufficient to make a dent in these tumors - direct radiosensitization of the tumor cells will also be necessary. 

Tang C et al. Definitive radiotherapy in lieu of systemic therapy for oligometastatic renal cell carincoma: a single-arm, single-centre, feasibility, phase 2 trial. Lancet Oncology 22:1732-1739, 2021.

Ordinarily we would not feature a clinical article about an adult tumor on the PROS website and newsletter. This paper, however, is of particular interest to anyone concerned with the management of oligometastatic cancer when systemic chemotherapy or biological therapy is relatively inefficacious and toxic. 

The authors show that in selected patients stereotactic body irradiation without chemotherapy for metastatic renal cell carcinoma facilitated deferral of further systemic therapy with good quality of life. 

It may be an approach worth considering in other tumors. 

 

Edward C. Halperin MD MA

 

 

 

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