Letters in Oncology Science is an interdisciplinary quarterly journal of the Oncology Centre of Wielkopolska (Polonia Major) Region, aimed at researchers and practicing specialist physicians engaged in studies in the following areas: oncology, diagnostics of oncologic diseases, planning treatment of oncologic diseases, radiotherapy, chemotherapy, immunotherapy, dosimetry, nuclear medicine, research of cancer biology, molecular biology of cancer, oncologic care, radiobiology, physiotherapy.
Wszyscy autorzy pracy muszą wyrazić pisemną zgodę na jej publikację. Oświadczenie pierwszego autora, że wszyscy współautorzy zapoznali się z praca i wyrazili zgodę na jej publikację jest również akceptowane. W momencie przyjęcia pracy do publikacji wszelkie prawa do jej wykorzystania przechodzą na właściciela czasopisma i jego praw autorskich. Praca nie może zostać opublikowana w żadnym innym wydawnictwie do czasu wykorzystania jej przez Redakcję Czasopisma. Po opublikowaniu praca pozostaje własnością Wielkopolskiego Centrum Onkologii, a jakiekolwiek jej wykorzystanie w całości lub w części, bez względu na nośnik i język, możliwe jest tylko po uzyskaniu pisemnej zgody Redakcji, która jest wyłącznym wydawcą i dystrybutorem czasopisma , z podaniem źródła.
Teranostyka w Europie - współczesna terapia radioligandowa.
Celem niniejszej pracy jest omówienie zagadnień związanych z Teranostyką – jej podstawami, zastosowaniami, jak również – przedstawienie obecnego stanu wiedzy dotyczącego Teranostyki i jej perspektyw ze szczególnym uwzględnieniem ewolucji terapii w Europie.
Copyright (c) 2026 Letters in Oncology Science https://creativecommons.org/licenses/by-nd/4.0
Rola podjednostki katalitycznej kompleksu remodelującego chromatynę ISWI, SMARCA1, w regulacji ekspresji genów
Gen SMARCA1 koduje białko SNF2L, należące do rodziny ATPaz zależnych od chromatyny z podrodziny ISWI, które odgrywa kluczową w remodelowaniu chromatyny i regulacji ekspresji genów. W ostatnich latach rosnące zainteresowanie funkcją SMARCA1 zaowocowało licznymi badaniami, które wskazują na jego istotne znaczenie w rozwoju układu nerwowego, różnicowaniu komórek oraz utrzymaniu homeostazy epigenetycznej. Mutacje i zaburzenia regulacji SMARCA1 zostały powiązane z licznymi rodzajami nowotworów. W niniejszej pracy zebrano aktualny stan wiedzy na temat budowy, ekspresji, funkcji biologicznych oraz znaczenia klinicznego SMARCA1, wskazując na potencjalne zastosowanie tej wiedzy w dziedzinie onkologii.
Copyright (c) 2025 Letters in Oncology Science https://creativecommons.org/licenses/by-nd/4.0
Scyntylatory i ich zastosowanie – artykuł przeglądowy
Postępujący rozwój technologii medycznych wykorzystujących promieniowanie jonizujące, w szczególności w dziedzinach diagnostyki obrazowej oraz planowania i realizacji leczenia radioterapeutycznego, stawia coraz wyższe wymagania w zakresie precyzji, rozdzielczości i dokładności pomiarowej. W odpowiedzi na rosnące potrzeby kliniczne, rozwój detektorów promieniowania jonizującego stał się jednym z kluczowych obszarów badań. Szczególną rolę w tym kontekście odgrywają scyntylatory, które dzięki szerokiemu spektrum zastosowań znajdują istotne miejsce zarówno w diagnostyce, jak i w terapii onkologicznej. Aktualne badania nad scyntylatorami koncentrują się na poprawie ich czułości oraz rozdzielczości czasowej i przestrzennej, co umożliwi bardziej precyzyjne pomiary dawek. Ma to szczególne znaczenie w nowoczesnych technikach leczenia, takich jak stereotaktyczna radioterapia ciała (SBRT) oraz radioterapia protonowa, w których dokładność i kontrola rozkładu dawki są krytyczne dla optymalizacji wyników terapeutycznych. Wraz z intensywnym rozwojem inżynierii materiałowej, umożliwiającym projektowanie i wytwarzanie coraz bardziej zaawansowanych detektorów opartych na efekcie scyntylacyjnym, oraz ze wzrostem ich zastosowania w nowoczesnej medycynie, zwłaszcza w diagnostyce obrazowej i radioterapii, zauważalna jest potrzeba systematycznego przeglądu osiągnięć w tej dziedzinie. Niniejsza praca omawia zarówno podstawy fizyczne efektu scyntylacyjnego, jak i historię jego wykorzystania w detekcji promieniowania jonizującego. Przedstawiono także kluczowe wyzwania związane z zastosowaniem scyntylatorów w dozymetrii promieniowania oraz dokonano przeglądu dostępnych materiałów wykazujących efekt scyntylacyjny wraz z analizą ich właściwości i zastosowań.
Assessment of geometric verification to determine the setup uncertainty margin in lung cancer patients.
Aim The aim of the study was to evaluate the results of geometric verification by determining systematic and random errors to establish the setup margins (SM) for patient positioning uncertainty in a group of lung cancer patients. Material and Method The study included 20 patients treated with the Volumetric Modulated Arc Therapy (VMAT) technique with respiratory gating. The prescribed dose was 60 Gy in 30 fractions. The Planned Target Volume (PTV) averaged 247.62 cm³ (range 62.10–562.10 cm³). The PTV volume included the anatomical volume, accounting for tumor positions due to respiratory motion (Internal Target Volume, ITV), which was defined based on 4DCT (Four-Dimensional Computed Tomography) imaging at selected respiratory phases covering inhalation ±20% of the respiratory cycle, along with a setup margin (SM) of 0.5 cm. Respiratory motion was monitored using the Real-time Position Management (RPM) System. Patients were positioned with their arms above their heads using dedicated immobilization to stabilize the patient’s position. During each fraction, the patient's position was verified based on Cone Beam CT (CBCT) in four dimensions (4D CBCT). Based on the collected shift results in the cranio-caudal (Lng), anterior-posterior (Ver), and left-right (Lat) axes, the displacement vector (V) was calculated, as well as the systematic (∑) and random (σ) errors. Using these errors and applying the van Herk formula (PTV margin = 2.5∑ + 0.7σ), the setup margin (SM) was determined [van Herk M, Remeijer P, Rasch C, Lebesque JV. The probability of correct target dosage: dose-population histograms for deriving treatment margins in radiotherapy. Int J Radiat Oncol Biol Phys. 2000;47:1121-35]. Results 600 geometric shift results were collected, with the mean values and standard deviations in the respective axes (Lng, Ver, Lat) being 0.192 ± 0.241 cm, 0.047 ± 0.234 cm, and 0.020 ± 0.239 cm, respectively. The displacement vector (V) was 0.425 ± 0.169 cm. The systematic error (∑) in each axis was 0.134 cm, 0.139 cm, and 0.136 cm, while the random error (σ) was 0.236 cm, 0.220 cm, and 0.233 cm. Based on these values, the SM margin was calculated to be 0.499 cm, 0.500 cm, and 0.502 cm, respectively. Conclusions Based on the obtained results of geometric verification, it was concluded that for the applied patient positioning method for lung cancer patients treated with VMAT and respiratory gating, the adopted setup margin (SM) of 0.5 cm is consistent with the margin determined from the analyzed results of geometric verification.
The role of radioisotope imaging techniques in the breast cancer diagnosis
Breast cancer is the most common oncological disease among women worldwide characterized by a high mortality rate despite the dynamic development of diagnosis and therapy. The oncologic therapy effectiveness depends strongly on early detection and precise staging of the breast cancer. Among the available methods of imaging, one of the most useful seems to be Nuclear Medicine scanning, mainly: positron emission tomography-computed tomography (PET-CT) using the using the radiopharmaceutical fluorine-18F-fluorodeoxyglucose - a glucose analogue labeled with the fluorine-18 isotope (2-deoxy-2-[18F]fluoro-D-glucose, 18F-FDG). So called radioisotope imaging ensures the anatomic and metabolic diagnostic imaging, helpful in the breast cancer staging and restating. Nevertheless, this is just an example among the available and useful in the evaluation of breast cancer techniques or radiopharmaceuticals, which are increasing in number and availability due to the significant development of the nuclear medicine field in recent years.
positron emission tomography-computed tomography
The role of modern methods of imaging carotid artery stenosis occurring as a late post-radiation effect after radiotherapy for head and neck cancer.
Abstract Head and neck cancer is an increasingly diagnosed cancer among oncology patients around the world. Due to the location and severity in many cases the most frequently used treatment method is radiotherapy. The highly toxic radiation beam damages not only tissues affected by cancer but also healthy tissues, including blood vessels located close to the clinical target volume. Carotid artery stenosis appears as a late side effect of radiation treatment for head and neck cancer. Stenosis of the carotid artery is associated with increased risk of ischemic stroke, therefore routine screening is important. Diagnostic modalities used for screening include DUS, DSA, CTA, MRA and PET/CT. Doppler ultrasonography is the method of choice for assessing carotid artery stenosis.
Carotid artery stenosis, duplex ultrasound, digital subtraction angiography, computed tomography angiography, magnetic resonance angiography
Radioisotope studies in the breast cancer assessment: radiopharmaceuticals and techniques overview
The breast cancer is currently the most commonly diagnosed malignant tumor among women. Different histological background and the disease’s staging determine various therapeutic approaches. The staging of the disease depends on the histologic and diagnostic assessment’ conclusions, coming from multiple methods used for the breast cancer evaluation. Nuclear medicine imaging, called radioisotope studies seems particularly helpful in the overall breast cancer patients management.
The Role of Multi-Omics in Breast Cancer Diagnosis and Research
Breast cancer is the most common malignancy among women and a leading cause of cancer-related mortality. Despite significant advances in detection and treatment, its molecular heterogeneity poses challenges in achieving accurate diagnosis and personalized therapies. Traditional diagnostic methods, based primarily on histopathology and genomics, fail to capture the full complexity of the disease. In response, multi-omics approaches, integrating genomics, transcriptomics, proteomics, and metabolomics, are emerging as powerful tools for comprehensive cancer profiling. These advanced methodologies enable the identification of novel biomarkers, improve diagnostic accuracy, and facilitate patient stratification for tailored treatments. This review explores the role of multi-omics in breast cancer diagnosis, emphasizing recent technological advancements and key findings that enhance early detection, prognosis, and treatment strategies. By providing a more complete molecular picture, multi-omics is paving the way for precision medicine, offering the potential for more effective and personalized breast cancer therapies.
YSF 2.0 is a conference aimed at young scientists and students below 35 years of age, specializing in oncology-related sciences (including basic sciences such as biology, medical physics, genetics, biotechnology, pharmacy), as well as young clinicians, pathomorphologists, medical physicists and radiographers interested in therapy and diagnostics. The forum is an ideal place not only to present one's work but also to exchange professional experiences and form brand new international cooperation networks. The conference will be conducted in English in a hybrid form: on-line and on-site on the premises of the Greater Poland Cancer Centre. The Forum is under the honorary scientific patronage of Professor Julian Malicki - the Director of the Greater Poland Cancer Centre. The Forum has a competitive character. Abstracts submitted by participants will be evaluated by the Jury and reviewed by experts in basic and clinical sciences.
Analiza statystyki dawek w narządach krytycznych dla zmian nowotworowych zlokalizowanych w odcinku piersiowym i lędźwiowym kręgosłupa leczonych z intencją paliatywną w stereotaktycznym zrobotyzowanym systemie CyberKnife
Celem pracy jest analiza statystki dawek w narządach krytycznych dla zmian nowotworowych zlokalizowanych w kościach leczonych paliatywnie dla planów zrealizowanych za pomocą stereotaktycznego zrobotyzowanego systemu CyberKnife. Wybrano 15 pacjentów, którym zostały wcześniej przygotowane plany leczenia w dedykowanym systemie planowana leczenia. Grupę stanowili pacjenci ze zmianami nowotworowymi zlokalizowanymi w kręgosłupie piersiowym oraz lędźwiowym o różnej liczbie frakcji (1, 3, 5) i dawce zadanej od 16 Gy w pojedynczej frakcji do dawki zadanej 30 Gy w 5 frakcjach. Analizie poddano różnice dawek maksymalnych z dawkami tolerancji dla poszczególnych narządów krytycznych. W wyniku analizy porównawczej statystyki dawek pochłoniętych w wybranych planach leczenia z dawkami tolerancji w narządach krytycznych dla zmian nowotworowych zlokalizowanych w odcinku piersiowym i lędźwiowym kręgosłupa leczonych z intencją paliatywną w stereotaktycznym zrobotyzowanym systemie CyberKnife, stwierdzono , że dla wszystkich narządów krytycznych znajdujących się w odcinku piersiowym i lędźwiowym kręgosłupa spełniono dawki tolerancji zgodnie z raportem Grimm i et al. 2011r. [6].
Copyright (c) 2024 Letters in Oncology Science https://creativecommons.org/licenses/by-nd/4.0
Lung Cancer Detection Using Convolutional Neural Networks
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Name="List Table 7 Colorful Accent 6"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Mention"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Smart Hyperlink"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Hashtag"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Unresolved Mention"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Smart Link"/> </w:LatentStyles> </xml><![endif]--><!-- [if gte mso 10]> <![endif]--> Lung cancer is among the most prevalent and deadly cancers worldwide. Accurate diagnosis and early detection are critical for improving lung cancer patient outcomes and survival rates. Thanks to developments in medical imaging technology, computer-aided diagnosis (CAD) systems have shown a great deal of promise in helping radiologists identify and diagnose lung cancer from medical images. Here, we present the use of convolutional neural networks (CNNs) to create an early detection system (CAD) for lung cancer. The suggested approach uses lung computed tomography (CT) scans as input and use a CNN architecture to extract high-level features from the pictures. We use transfer learning to enhance a CNN model trained on a large dataset of CT images. The CNN model has been taught to determine if a specific CT image contains lung cancer or not. We evaluate the performance of the proposed CAD system on a dataset of CT scans of the lungs from different institutions. The trial's results show that our CNN-based CAD system can reliably and precisely identify lung cancer from CT scans. We also show the comparative performance of our proposed system against the state-of-the-art machine learning methods for lung cancer prediction. In conclusion, the suggested CNN-based deep learning-based CAD system has produced encouraging results for lung cancer detection from CT scans. The approach might help radiologists identify and classify lung cancer early on, leading to better patient outcomes and survival rates. The viability and usefulness of the suggested approach in clinical practice require more study
Radiotherapy of the left breast - comparison of treatment using the DIBH respiratory gating technique with the free-breathing technique.
Breast cancer is the most common cancer in women. Radiotherapy is a very important part of the treatment of this cancer. As breast cancer patients survive longer, any long-term side effects caused by treatment become increasingly important. The aim of this study is to determine whether deep breath-hold (DIBH) respiratory-gated radiotherapy is superior to free-breathing (FB) radiotherapy in reducing cardiac exposure. The analysis included 50 patients treated in 2022-2023 for left breast cancer who underwent breast-conserving surgery. The obtained data allow us to conclude that DIBH is a more advantageous technique than FB. There is a visible decrease in the average dose to the heart from 3.29±1.77Gy to 1.43±0.54Gy, V20 to the heart from 5.14±4.95% to 0.67±0.81% in favor of DIBH. A slightly smaller difference, but still supporting the DIBH technique, is for the doses received by the left lung, i.e. a decrease in the average value from 7.39±2.21Gy to 7.14±1.9Gy, and in V20 from 15.42±5.17 % to 14.55±3.92%.
The motion of the patient's anatomical structures may affect the accuracy of its delivery. There are different methods of dealing with organ movement while delivering treatment. The aim of the study was to review solutions dealing with the respiratory motions of patients. Compensation of this motion during irradiation with external beams and control and monitoring systems have been presented and discussed. In addition to the methods used on classical linear accelerators, the respiratory tracking technique used on the CyberKnife was presented.
Copyright (c) 2023 Letters in Oncology Science https://creativecommons.org/licenses/by-nd/4.0
Mechanisms of DNA damage repair and activation of anticancer immunity
Disruption of DNA damage response mechanisms can lead to replicative and transcriptional stress, accumulation of mutations and cytosolic DNA and even cell death. They can also result in malignant transformation, leading to development of breast, ovarian, colorectal, gastric or pancreatic cancer. Regulation of DNA repair processes, however, has applications in cancer therapy through activation of both the body's innate and adaptive immune response. This paper addresses the cGAS-STING system, which plays a key role in the detection of cytosolic DNA, the use of DNA repair element inhibitors (PARPi) in cancer therapy, and provides an overview of the activation of the anti-cancer response related to repair mechanisms such as homologous recombination.
HyperArc as a modern method of stereotactic radiosurgery for the treatment of intracranial cases
Single-fraction SRS stereotactic radiosurgery is commonly used for brain tumors and intracranial metastases. It uses high-dose ionizing radiation while sparing healthy tissues. The aim of this study was to present and analyze the modern HyperArc stereotactic technique implemented on a classic linear accelerator with an MLC multileaf collimator. HyperArc is a special type of VMAT (Volumetric modulated arc therapy) technique that is an alternative solution to stereotactic radiosurgery (SRS). It enables the use of the isocentric technique for the simultaneous irradiation of many tumors in the brain area on a classic linear accelerator with a multileaf MLC collimator and also allows you to set different dose values ​​for individual tumors in one treatment plan. Through optimization, we avoid high doses in healthy tissue and between target volumes. Compared to other stereotactic techniques, it enables a much shorter irradiation time, similar to the treatment time in dynamic VMAT or IMRT Intensity modulated radiation therapy) techniques.
stereotactic radiosurgery, HyperArc, treatment planning
The ovarian tumours’ diagnosis - the role of PET/CT study
The ovarian cancer is the seventh most commonly diagnosed cancers and the fourth cause of death due to the oncological disease. Due to a high tumours’ aggressiveness, the fast and precise diagnostic management is vital for the therapy to be successful. Among the available diagnostic methods, used for detection, staging and therapy planning, the particularly useful seem the radioisotope imaging techniques, mainly the positron emission tomography/computer tomography (PET/CT).
Overview of irradiation techniques for esophageal cancer.
Rak przełyku stanowi około 2% wszystkich nowotworów złośliwych. Zastosowanie leczenia u pacjenta z rakiem przełyku zależy od dokładnej lokalizacji nowotworu i jego stadium. Pacjenci ze zmianami naciekającymi naczynia krwionośne, serce, płuca i węzły chłonne kwalifikują się do radykalnej chemioradioterapii. Celem tego badania było przejrzenie technik napromieniowania w przypadku raka przełyku. W tym artykule przedstawiono techniki konwencjonalnej radioterapii 2D i 3D konformalnej radioterapii (3DCRT). Systemy komputerowe do planowania leczenia wpłynęły na rozwój dynamicznych technik, umożliwiając nowocześniejszą radioterapię z modulacją intensywności (IMRT) i terapię łukiem wolumetrycznym (VMAT) lub stosowanie terapii protonowej.
Cervical cancer in the Polish population- preventive actions review
Cervical cancer (CC) remains one of the primary health concerns for women worldwide, with its prevalence in Poland posing a significant health challenge. Despite advancements in preventive treatments, this disease persists as one of the leading causes of morbidity and mortality among women. In Poland, its impact extends beyond individual health and patient quality of life, also affecting the healthcare system and the nation's economy.
Porównanie rozkładów dawek dla radioterapii stereotaktycznej nowotworu płuc dla dwóch technik dynamicznych IMRT i VMAT
Celem pracy było porównanie rozkładów dawek dla radioterapii stereotaktycznej nowotworu płuc dla dwóch technik dynamicznych: techniki radioterapii z modulowaną intensywnością dawki (IMRT, ang. Intensity Modulated Radiation Therapy) i techniki obrotowej z modulacją intensywności dawki (VMAT, ang. Volumetric Modulated Arc Theraphy). Grupę badawcza stanowiło 5 pacjentów z nowotworem zlokalizowanym w prawym płucu, średnica guza na obrazach tomografii komputerowej nie przekraczała 5 cm. Podczas przygotowania pacjenta do radioterapii wykonano czterowymiarową tomografię komputerową (4DCT, ang. four dimension computer tomography). Dawka zadana dla planowanej objętości leczenej (PTV, ang. Planning Target Volume) wynosiła 50 Gy w 5 frakcjach, zastosowano energię 6 MV bez filtra spłaszczającego (FFF, ang. Flatening Filter Free). Dla każdego z planów leczenia wykonano weryfikacje dozymetryczną, zrealizowaną z wykorzystaniem stałego fantomu dozymetrycznego OCTAVIUS 4D oraz matrycy OCTAVIUS 1600 SRS (PTW, Freiburg, Niemcy). Plany zostały porównane metodą analizy gamma w podejściu lokalnym dla następujących parametrów: DD (ang. dose diffrence – różnica dawki) 2%, DTA (ang. distance to agreement – dopuszczalna odległość między punktami) 2 mm, próg odcięcia niskich dawek: 5% dawki maksymalnej, akceptowalny odsetek punktów spełniających kryteria analizy gamma > 95%. Dla objętości PTV przeanalizowano następujące parametry: wartości dawki zdeponowanej w 98% oraz 2% objętości PTV oraz dawki, które otrzymały narządy krytyczne. Dawki dla OAR były zgodne z dawkami toleracji opisanymi w raporcie QUANTEC (ang. Quantitative Analyses of Normal Tissue Effects in the Clinic). Wykazano, że w technice IMRT narządy krytyczne otrzymują nieznacznie wyższe dawki, lecz nie przekraczające dawek tolerancji. Ze względu na liczbę wiązek terapeutycznych dla techniki IMRT czas leczenia był znacznie dłuższy niż dla techniki VMAT.
Porównanie rozkładów dawek dla nowotworu odbytnicy dla dwóch pozycji pacjenta w trakcie procesu napromieniania: pozycja na plecach i na brzuchu.
Celem pracy było porównanie rozkładów dawek planów wykonanych techniką obrotową z modulacją intensywności dawki VMAT (ang. Volumetric Modulated Arc Theraphy) dla nowotworu odbytnicy dla dwóch pozycji pacjenta: pozycji na plecach i na brzuchu. Wybrano retrospektywnie pacjentów do dwóch grup, każda składała się z 10 pacjentów. Dla każdego pacjenta wykonano plan leczenia w technice VMAT z zastosowaniem dwóch lub trzech łuków o energii 6 MV, z wykorzystaniem akceleratora liniowego TrueBeam. Dawka zadana wynosiła 25 Gy w 5 frakcjach. W planach przeanalizowano następujące parametry: wartości dawki zdeponowanej w 98% i 2% objętości PTV oraz wartość dawek jakie otrzymały narządy krytyczne. W grupie pacjentów leczonych w pozycji na brzuchu wykazano redukcję dawki w jelitach poprzez zmniejszenie objętości jelita w polu napromieniowania w porównaniu do ułożenia pacjenta w pozycji na plecach. Różnica dawek w innych narządach krytycznych jest nieznaczna.
Porównanie rozkładów dawek dla napromieniania mózgu dla technik dynamicznych IMRT i VMAT oraz techniki 3DCRT
Whole-brain radiotherapy is a standard treatment for many brain metastases. Whole brain irradiation is a palliative treatment aimed at improving the patient's quality of life. Historically, this procedure was most often performed using two opposing side beams. However, as patients increasingly undergo repeated radiotherapy, dynamic techniques are used to minimize doses to critical organs. The study aimed to compare techniques used in whole brain irradiation in terms of dose analysis in critical organs (OAR, Organs at Risk). A group of 5 patients with brain metastases were qualified for the study. For each patient, a treatment plan was prepared using a static three-dimensional conformal radiotherapy technique (3DCRT) and two plans using a dynamic technique (IMRT, Intensity Modulated Radiation Therapy), and (VMAT, volumetric modulated arc therapy). All plans were compared with each other in terms of isodose coverage of 98% and 95% of the planned irradiation volume (PTV, Planning Target Volume) and the dose in 2% of the PTV volume, maximum doses in the OAR: lenses, eyes and in the left and right optic nerve. Mean maximum lens dose values ​​were below tolerance dose values but with better lens protection in favor of dynamic techniques; the average value of the maximum dose for the eyes and optic nerve was very similar consistent with the tolerance doses. Dynamic techniques enable better coverage of the PTV volume with the administered dose and minimize doses administered to critical organs.
Planning radiotherapy for patients with a cardiac stimulating system
The increase in the survival curve of cancer patients and more and the improvement of diagnostic methods have contributed to an increase in the number of patients with pacemakers who are undergoing radiotherapeutic treatment. There are many risk factors, but having an electronic heart stimulation system should not be a contraindication to treatment. Planning such treatment is quite a challenge, because ionizing radiation is not neutral to this type of devices. Medical physicists and radiotherapists should apply the ALARA (As Low As Reasonably Achievale) when planning radiotherapy. A number of guidelines have been developed that should be followed to reduce the risk of damage to the stimulator.
The comparison of gold nanoparticles effectiveness in 2D and 3D cell culture.
The creation of cell cultures for scientific purposes has made it possible to obtain new knowledge and consequently to make discoveries in the field of cell biology or biophysics. In vitro studies allow for the observation of cell lines as well as interactions with introduced substances or materials. They have an invaluable contribution to the development of nanomedicine, which is attracted a lot of interest. Gold nanoparticles (GNPs) are particularly popular and promising, especially in terms of cancer therapy. This is due to the specific (e.g. electrical, magnetic, optical, mechanical) properties of nanoparticles, significantly different from gold particles of macro size. Unfortunately, the results of in vitro studies are sometimes inconsistent with in vivo studies. Nanoparticles that work well at the cellular level are not always as effective in animal models. The reason for this is the multiplicity of complex metabolic processes occurring in the body during in vivo studies. Most cell studies are performed on two-dimensional structures that approximate real-world conditions. Currently, none of the in vitro techniques is able to reflect the identical physiological conditions prevailing in animal models. However, modern science can map them more precisely using 3D culture, which is much more complex and less efficient. When designing new studies, the advantages and disadvantages of each of the mentioned cell culture methods should be considered. The purpose of this publication is to present the differences between two-dimensional and three-dimensional (3D) cell cultures, taking into account the use of gold nanoparticles.
Teranostyka ma na celu indywidualizację postępowania diagnostycznego i terapeutycznego. Obecnie Theranostics jest najczęściej stosowany w diagnostyce i terapii pacjentów z guzami neuroendokrynnymi oraz rakiem prostaty. Głównym celem Theranostics jest wykorzystanie radiofarmaceutyków umożliwiających obrazowanie i leczenie choroby. Lutet-177 i aktyn-225 to obecnie najczęściej stosowane radioznaczniki w teranostyce.
Radiotherapy after radical prostatectomy
Local treatment following radical prostatectomy used in prostate cancer patients with risk factors of recurrence or with biochemical recurrence and/or local recurrence consists of adjuvant and salvage radiotherapy. The postprostatectomy biochemical failure, according to some studies based on ten years of follow-up, is estimated at one-third of patients. It remains challenging to extract those patients who may benefit from implementing radiotherapy while minimizing the risk of overtreatment. Adjuvant radiotherapy is considered in a situation of the absence of biochemical recurrence with the presence of high-risk features in pathological staging defined as positive surgical margins (R1), extraprostatic extension (pT3a), or seminal vesicle invasion (pT3b) and Gleason score 8-10. Failure rate after RP is found approximately in 50% of men diagnosed with adverse pathologic features. It is recommended to implement adjuvant radiotherapy in case of very aggressive form of prostate cancer (pT3b, Gleason 8-10) without awaiting biochemical recurrence. However, salvage radiotherapy represents a therapeutic option for patients experiencing biochemical recurrence in case of no distant metastasis. Monitoring of serum PSA levels in each individual is crucial in deciding whether salvage radiotherapy is needed. The effectiveness of treatment increases along with early initiation of radiation therapy. Current guidelines developed by NCCN and EAU regard conversion of PSA from undetectable to detectable level as a sign of cancers’ recurrence. In addition, prostate-specific membrane antigen (PSMA) PET should be used as a part of modern imaging diagnostics for a precise determination of disease extent.
Copyright (c) 2022 Letters in Oncology Science https://creativecommons.org/licenses/by-nd/4.0
Cellular senescence in cancer: a brief review
Certain cancer treatments cause an increase in the number of senescent cells in cancer and nonmalignant cells. Senescence which is characterized by telomere shortening, DNA damage, and improper expression of oncogenes are all examples of triggers that cause cellular senescence. Failure to rejoin the cell cycle after mitotic stimulation, resistance to cell death, and an increased secretory phenotype are all signs of senescence. A rising number of studies point that spontaneous senescence and therapy-induced senescence (TIS) play a strong role in cancer aggressiveness. Senescent cells may have a role in oncogenesis mainly through the senescence associated secretory phenotype (SASP), which produces an immunosuppressive environment. This aids in tumor development and relapse by secreting factors such as IL-6, IL-8, CCL5, VEGF, and CXCL5 that contribute to cell proliferation, migration, invasiveness, angiogenesis, and epithelial–mesenchymal transition (EMT) as well as immune-mediated clearance.
Comparison of commercially available detectors used for the dosimetry of the High Energy Electron Beams.
In modern radiotherapy, electron beams are used less and less often. However, there are still techniques where this type of particles is irreplaceable, like intraoperative radiotherapy (IORT) or total skin electron irradiation (TSEI). Due to low range of electrons penetrating the medium, dosimetric measurements and beam characteristics are challenging. One of the most important steps during this process is to select the right detector in order to collect reliable data. The purpose of this work was to perform beam characteristics using six commercially available detectors: Semiflex 3D (Type 31021), Advanced Markus (Type 34045), Markus (Type 23343), Roos (Type 34001), microDiamond (Type 60019), Diode E (Type 60017). Collected data shows various parameters describing electron beams, depending on the used detector. Obtained results showed that the most useful detector for beam characteristics is microDiamond Type 60019. Thanks to the very small effective volume, microDiamond showed a superior spatial resolution, which is especially handful during the measurements of dose profiles, allowing estimating beam parameters very precisely.
Proposing a treatment plan strategy for VMAT plans in the event of unavailability of a source linear accelerator or other compatible linacs at a radiotherapy center
The study aimed to propose a strategy for dealing with a SIB treatment plan performed using VMAT (Volumetric Modulated Arc Therapy) dynamic technique in the case of unavailability of the source device and no compatible linear accelerator in the center. The study was based on 20 patients with prostate cancer treated with simultaneous integrated boost (SIB) with VMAT treatment plan for two or three full arches. Subsequently, 7-field IMRT (Intensity Modulated Radiation Therapy) replacement plans were made based on the original treatment plans. For the VMAT and IMRT plans, a beam of 6 MeV energy was used with a set dose of 67,5 Gy for PTV (Planning Target Volume) of the prostate and 45 Gy for PTV of the nodes in 30 fractions. The dose differences between VMAT and IMRT technique for PTV volume s did not exceed the acceptable limit - of 2%. For critical organs, the difference in dose was within the tolerance doses described in the report QUANTEC (Quantitative Analyses of Normal Tissue Effects in the Clinic). Conformity index CI (Conformity Index) values for plans in VMAT technique were between 0,53 and 0,58, and for plans in IMRT, between 0,49 and 0,54. The total number of monitor units for the VMAT technique was between 626 and 777 MU, for the IMRT plan the minimum number of MU was 2013 MU, and the maximum was 2766 MU. Studies have shown that for PTV, despite the minor differences obtained for doses in critical organs, while falling within the criteria for tolerable doses and longer irradiation times, the SIB-IMRT technique can be used as an alternative treatment plan for the patient without compromising the quality of treatment.
Fluorine-18F-fluorodeoxyglucose PET-CT in colorectal cancer staging
Positron emission tomography/computed tomography using the radiopharmaceutical fluorine-18F-fluorodeoxyglucose (18F-FDG PET-CT) has been recognized as useful method of colorectal cancer staging, restaging, and therapy planning. The 18F-FDG PET-CT technique seems to be particularly helpful in colorectal cancer staging considering the possibility of a whole-body imaging during one acquisition. The method of choice in the evaluation of colorectal cancer is MRI, however, the PET-CT technique is used in case of ambiguity of the obtained results or the necessity to exclude the presence of distant metastases to the skeletal system or distant organs.
colorectal cancer, 18F-fluorodeoxyglucose, positron emission tomography
Effect of the Normal Tissue Objective (NTO) on Dose Distribution in Prostate Cancer Treatment with Simultaneous Integrated Boost (SIB)
One of the most common cancers among men in Poland is prostate cancer, and one of the methods of its treatment is Simultaneous Integrated Boost (SIB). Technique allows the simultaneous delivery of different dose levels to different target volumes within a single treatment fraction. Due to the location between the sensitive organs, it is necessary to achieve a rapid dose gradient around Planning Target Volume (PTV) and one way to achieve this is to use The Normal Tissue Objective (NTO) in the Treatment Planning System (TPS) Eclipse (Varian Medical Systems, Palo Alto, CA, USA). The study compares plans without NTO, automatic NTO and with different combinations of the priority p (50, 200 and 500) and the fall-off k (0.05, 0.2 and 1). For the evaluation of the plans, dose distributions, conformity index (CI) and gradient index (GI) as well as doses in organs at risk (OAR) were compared. The dose distribution shows that NTO is an effective tool for dose reduction around PTV. The conformity index determines the adjustment of the isodose shape to the target area and remained at a similar level on all plans, with an average value of 0.529 ± 0.196. The gradient factor is the difference between the equivalent sphere radius of the prescription and half-prescription isodoses, so its lower value means a greater dose decrease beyond PTV. This is visible for higher priority plans, but unfortunately it is related to a decrease in PTV coverage. Dose analysis in OAR showed that NTO used in prostate cancer planning, probably due to its anatomical location, does not have a significant dose reduction effect. Further research using a larger sample and different NTO parameters or changing the location of interest is needed.