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Personalized radiotherapy 'start of a new era' with aid of radiomics imaging

por John W. Mitchell, Senior Correspondent | June 08, 2017
Rad Oncology Radiation Therapy
A team of radiation oncologists at the Moffitt Cancer Center in Florida want to do for radiation oncology patients what chemotherapy patients have benefitted from for years: receive treatment that is individualized, based on genomic biomarkers.

"We want to bring individualized radiation treatment, based upon specific gene signatures, tumor type, and patient response, to improve outcome and reduce toxicity," Louis B. Harrison, M.D., chair of the Radiation Oncology Department at Moffitt, told HCB News. "The current paradigm is to treat every patient with the same cancer and the same stage with the same radiation program. To make this care individualized is truly an exciting development."

Radiation therapy is one of the most common treatments to fight cancer. About 500,000 people a year received such treatments, according to Moffitt data. Harrison said the individualized protocols are made possible by the radiosensitivity index (RSI), developed at Moffitt under the leadership of Javier Torres-Roca, M.D. Details of the RSI road map were just published by Harrison, Torres-Roca and another colleague, Jimmy Caudell, M.D., Ph. D., in the May issue of The Lancet Oncology.

The RSI is a mathematical algorithm validated in multiple different groups across tumor types. Harrison said that when the index is combined with the field of radiomics, mathematical modeling and adaptive response evaluation, including the use of MR and CT scans during radiation therapy, the case for individualized treatment is even more likely.

Current treatment is limited by the fact that there has not been biological data (biopsies and 2-D imaging, as opposed to 3-D modeling and the RSI) to guide adaptive changes for individualized radiation treatment.

Harrison said that Caudell and Torres-Roca would be initiating a clinical trial in oropharynx cancer at Moffitt later this year to test the RSI model in patients."

"This is a cancer that is highly curable, and we think we can accomplish good outcomes with lower doses of radiation," said Harrison. "Lower doses mean fewer side effects, and less cost, so personalized treatment offers a lot of benefit to the patient. This is the start of new era in radiation oncology."

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