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COVID-19 and information and communication technology in radiation oncology:A new paradigm

World Journal of Clinical Oncology 2020年第12期11卷 968-975页

作者： Castalia Fernández Virginia Ruiz felipe couñago Department of Radiation Oncology GenesisCare MadridMadrid 28043Spain Department of Radiation Oncology Hospital Universitario de BurgosBurgos 09006Spain Department of Radiation Oncology Hospital Universitario Quirónsalud MadridMadrid 28028Spain Department of Radiation Oncology Hospital La LuzMadrid 28028Spain Department of Radiation Oncology Universidad Europea de MadridMadrid 28028Spain

Due to coronavirus disease 2019 pandemic caused by severe acute respiratory syndrome coronavirus 2,there has been a major reallocation of resources that has impacted the treatment of many diseases,including *** growing use of information and communication technologies(ICT),together with a new approach to work aimed at ensuring the safety of health care professionals and patients alike,has allowed us to maintain the quality of care while ensuring *** application of ICT to health care(eHealth)aims to significantly improve the quality,access to,and effectiveness of medical *** fact,the expanded use of ICT has been recognized as a key,cost-effective priority for health care by the World Health *** medical speciality of radiation oncology is closely linked to technology and as a consequence of coronavirus disease 2019,ICT has been widely employed by radiation oncologists worldwide,providing new opportunities for interaction among professionals,including telemedicine and e-learning,while also minimizing treatment *** research should concentrate on this emerging paradigm,which offers new opportunities,including faster and more diverse exchange of scientific knowledge,organizational improvements,and more efficient ***,these efficiencies will allow professionals to dedicate more time to patient care,with a better work-life *** the present editorial,we discuss the opportunities provided by these digital tools,as well as barriers to theirimplementation,and a vision of the future.

关键词： Radiation oncology COVID-19 Telemedicine Telehealth Distance learning Medical education Patient care Information technology Social media

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Stereotactic body radiation therapy:A good dance partner of oligometastatic non-small cell lung cancer to the sound of SINDAS study

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World Journal of Clinical Oncology 2020年第12期11卷 983-989页

作者： Xabier Mielgo-Rubio Javier Garde-Noguera Oscar Juan felipe couñago Department of Medical Oncology Hospital Universitario Fundación AlcorcónMadrid 28922Spain Department of Medical Oncology Hospital Arnau de VilanovaC/Sant ClimentValencia 46015Spain Department of Medical Oncology La Fe University HospitalValencia 46026Comunitat ValencianaSpain School of Medicine Catholic University San Vicente MartirValencia 46001Comunitat ValencianaSpain Department of Radiation Oncology Hospital Universitario Quirónsalud MadridHospital La LuzUniversidad Europea de MadridMadrid 28028Spain

The European Organization for Research on Treatment of Cancer Research published a consensus statement to establish the key criteria to define oligometastatic disease(OMD).According to those criteria,all lesions(both primary and metastatic)should be amenable to radical intent treatment with acceptable *** retrospective studies have shown that adding local ablative therapy to the treatment of OMD improves outcomes;however,due to the diverse selection criteria and treatment strategies used in those studies,it is difficult to compare directly results to draw definitive *** recent years,prospective phase II trials,such as the SABR-COMET and"Oligomez"trials,have shown that stereotactic body radiation therapy(SBRT)improves outcomes in patients with *** recently,interim results of the randomised phase 3 SINDAS trial were reported at the annual meeting of the American Society of Clinical Oncology 2020 demonstrating that upfront SBRT added to systemic treatment with tyrosine kinase inhibitors yielded a significant benefit in both progression-free survival and overall survival in patients with epidermal growth factor receptor-mutant oligometastatic non-small cell lung *** the present editorial,we review the definition and historical context of advanced non-small cell lung cancer with *** addition,we review the scientific evidence for local ablative therapy and SBRT and discuss the results of recently published prospective *** also discuss in depth the results of the SINDAS study,including the strengths and weaknesses of the study and the barriers to extrapolating these results to routine clinical practice.

关键词： Oligometastatic Non-small cell lung cancer Stereotactic body radiation therapy SINDAS Local ablative therapy Epidermal growth factor receptor mutations Epidermal growth factor receptor-mutated

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New standard in locally advanced rectal cancer

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World Journal of Clinical Oncology 2020年第12期11卷 990-995页

作者： Sebastián Solé Ramón Baeza Carolina Gabler felipe couñago Department of Radiation Oncology IRAM ClinicSantiago 7630294Chile Radiation Oncology Program Universidad Diego Portales Santiago 7630294Chile Department of Radiation Oncology Hospital Universitario Quirónsalud MadridMadrid 28223Spain Clinical Department Faculty of BiomedicineUniversidad EuropeaMadrid 28028Spain

In the following review we intend to ascertain the optimal neoadjuvant therapy inpatients with locally advanced rectal cancer. In 2004, a study revealed thatchemoradiotherapy (CRT) resulted in better local control when performedpreoperatively rather than postoperatively, thus neoadjuvant treatment wasestablished as a standard treatment. Subsequently, the Polish study and the Trans-Tasman Radiation Oncology Group showed no statistically significant differencebetween concomitant CRT over 5 wk vs short-course radiotherapy (RT).Therefore, both were established as standard neoadjuvant treatments. Later, theStockholm III study demonstrated that short-course RT had a higher completepathological response than long-course RT. It also showed that a delay betweenRT and surgery presented fewer complications. This opened a window of time toprovide an early and effective systemic treatment to prevent distant *** show that short-course RT plus oxaliplatin-based chemotherapy couldachieve this. When comparing this total neoadjuvant treatment (TNT) vsconcomitant CRT, the former showed greater complete pathological response andlower acute toxicity. Studies presented during 2020 have also shown the benefitsof TNT in terms of complete pathological response, as well as disease andmetastasis-free survival. Our review suggests that probably TNT should be thenew standard treatment for these patients. However, we will have to wait for thefull text publications of these studies to confirm this statement.

关键词： Locally advanced rectal cancer Total neoadjuvant treatment Short-course radiotherapy Oxaliplatin Neoadjuvant chemoradiotherapy Long-course radiotherapy

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Practice change in the management of metastatic urothelial carcinoma after ASCO 2020

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World Journal of Clinical Oncology 2020年第12期11卷 976-982页

作者： Pablo Gajate Javier Torres-Jiménez Carolina Bueno-Bravo felipe couñago Medical Oncology Department Hospital Universitario Ramón y CajalMadrid 28034Spain Urology Department Hospital Universitario Infanta SofiaMadrid 28703Spain Radiation Oncology Department Hospital Universitario Quirónsalud MadridHospital La LuzUniversidad Europea de MadridMadrid 28028Spain

Metastatic urothelial carcinoma(mUC)is an incurable and aggressive *** the past decades there have been few effective treatment options that have impacted the prognosis of mUC ***,in the last few years,several drugs have emerged as new treatment choices that are changing the therapeutic landscape of *** checkpoint inhibitors(ICIs)and targeted agents are useful treatment strategies that have been incorporated into our clinical ***,cisplatin-based chemotherapy is still the standard of care in the first-line of metastatic *** results of the JAVELIN Bladder 100 phase 3 trial were presented at ASCO 2020,this trial evaluated the role of avelumab,an ICI,as maintenance therapy in patients who had not progressed after first-line platinum-based *** trial met its primary endpoint demonstrating an overall survival benefit with avelumab *** addition,new drugs and combinations are being evaluated to improve the outcomes of second and subsequent *** growth factor receptor(FGFR)inhibitors and immunotherapy combinations were some of the strategies presented at ASCO 2020 that have shown promising ***,the development of predictive biomarkers that help us in the decision-making process will be one of the most important challenges in the next years.

关键词： Metastatic urothelial carcinoma Immune checkpoint inhibitors Avelumab JAVELIN Bladder 100 FGFR inhibitors ASCO 2020

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Magnetic resonance imaging for prostate cancer before radical and salvage radiotherapy: What radiation oncologists need to know

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World Journal of Clinical Oncology 2017年第4期8卷 305-319页

作者： felipe cou?ago Gemma Sancho Violeta Catalá Diana Hernández Manuel Recio Sara Montemui?o Jhonathan Alejandro Hernández Antonio Maldonado Elia del Cerro Department of Radiation Oncology Hospital Universitario Quirónsalud Madrid Clinical Department Faculty of BiomedicineUniversidad Europea Department of Radiation Oncology Hospital de la Santa Creu i Sant Pau Department of Radiology Fundació Puigvert Department of Radiology Hospital de la Santa Creu i Sant Pau Department of Radiology Hospital Universitario Quirónsalud Madrid Department of Radiation Oncology Hospital Universitario de Fuenlabrada Department of Nuclear Medicine Hospital Universitario Quirónsalud Madrid

External beam radiotherapy(EBRT) is one of the principal curative treatments for patients with prostate cancer(PCa). Risk group classification is based on prostate-specific antigen(PSA) level, Gleason score, and T-stage. After risk group determination, the treatment volume and dose are defined and androgen deprivation therapy is prescribed, if appropriate. Traditionally, imaging has played only a minor role in T-staging due to the low diagnostic accuracy of conventional imaging strategies such as transrectal ultrasound, computed tomography, and morphologic magnetic resonance imaging(MRI). As a result, a notable percentage of tumours are understaged, leading to inappropriate and imprecise EBRT. The development of multiparametric MRI(mp MRI), an imaging technique that combines morphologic studies with functional diffusion-weighted sequences and dynamic contrastenhanced imaging, has revolutionized the diagnosis and management of PCa. As a result, mpM RI is now used in staging PCa prior to EBRT, with possible implications for both risk group classification and treatment decisionmaking for EBRT. mpM RI is also being used in salvageradiotherapy(SRT), the treatment of choice for patients who develop biochemical recurrence after radical prostatectomy. In the clinical context of biochemical relapse, it is essential to accurately determine the site of recurrence-pelvic(local, nodal, or bone) or distant-in order to select the optimal therapeutic management approach. Studies have demonstrated the value of mpM RI in detecting local recurrences-even in patients with low PSA levels(0.3-0.5 ng/m L)-and in diagnosing bone and nodal metastasis. The main objective of this review is to update the role of mpM RI prior to radical EBRT or SRT. We also consider future directions for the use and development of MRI in the field of radiation oncology.

关键词： Prostate cancer Staging Radical radiotherapy Multiparametric magnetic resonance imaging Biochemical failure Radical prostatectomy Salvage radiotherapy

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Metastatic hormone-sensitive prostate cancer:How should it be treated?

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World Journal of Clinical Oncology 2021年第2期12卷 43-49页

作者： Fernando López-Campos Carmen González-San Segundo Antonio JoséConde-Moreno felipe couñago Department of Radiation Oncology Hospital Universitario Ramón y CajalMadrid 28034Spain Department of Radiation Oncology HGU Gregorio MarañonComplutense UniversityMadrid 28007Spain Department of Radiation Oncology Hospital Universitario y Politécnico La Fe.CEU Cardenal Herrera UniversityValencia 46026Spain Department of Radiation Oncology Hospital Universitario Quirón Salud MadridHospital La LuzUniversidad Europea de Madrid(UEM)Madrid 28223Spain

The number of treatment options for metastatic hormone-sensitive prostate cancer has increased substantially in recent *** classic treatment approach for these patients—androgen-deprivation therapy alone—is now considered *** randomized phase III clinical trials have demonstrated significant clinical benefits—including significantly better overall survival and quality of life—for treatments that combine androgen-deprivation therapy with docetaxel,abiraterone acetate,enzalutamide,apalutamide,and/or radiotherapy to the primary *** a result,these approaches are now included in treatment guidelines and considered standard of ***,the different treatment strategies have not been directly compared,and thus treatment selection remains at the discretion of the individual physician or,ideally,a multidisciplinary *** the range of available treatment approaches with varying toxicity profiles,treatment selection should be individualized based on the patient’s clinical characteristics and preferences,which implies active patient participation in the decision-making *** the present document,we discuss the changing landscape of the management of patients with metastatic hormonesensitive prostate cancer in the context of several recently-published landmark randomized *** addition,we discuss several unresolved issues,including the optimal sequencing of systemic treatments and the incorporation of local treatment of the primary tumour and metastases.

关键词： Metastatic hormone-sensitive prostate cancer Androgen-receptor signaling inhibitors Abiraterone acetate Enzalutamide Apalutamide Docetaxel

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New frontiers in focal therapy for prostate cancer:Prostate-specific membrane antigen positron emission tomography/magnetic resonance imaging

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World Journal of Clinical Oncology 2021年第2期12卷 61-68页

作者： Celeste Manfredi Esau Fernandez-Pascual Estefanía Linares-Espinós felipe couñago Juan Ignacio Martínez-Salamanca Department of Woman Child and General and Specialized SurgeryUrology UnitUniversity of Campania“Luigi Vanvitelli”Naples 81110Italy Department of Urology Hospital Universitario La PazMadrid 28046Spain LYX Institute of Urology Facultad de MedicinaUniversidad Francisco de VitoriaPozuelo de Alarcón 28223MadridSpain Radiation Oncology Hospital Universitario Quirónsalud MadridPozuelo de Alarcón 28223MadridSpain Department of Urology Hospital Universitario Puerta Hierro-MajadahondaMajadahonda 28222MadridSpain

Imaging has a central role in the context of focal therapy(FT)for prostate cancer(PCa).Prostate-specific membrane antigen(PSMA)positron emission tomography/magnetic resonance imaging(PET/MRI)is a novel imaging modality that combines the morpho-functional information of MRI with the molecular characterization of *** papers reported the potential advantages of PSMA PET/MRI in different clinical *** evidence on PSMA PET/MRI is available in the setting of *** PET/MRI can be an effective imaging modality for detecting primary PCa and seems to provide accurate local staging of primary *** PET/MRI also shows high performance for restaging and detecting tumor *** higher soft-tissue contrast and the reduction of ionizing radiation are the main advantages reported in the literature compared to PET/computed *** PET/MRI could represent a turning point in the management of patients with PCa in the context of *** studies are needed to confirm its applications in this specific clinical setting.

关键词： Prostate-specific membrane antigen Positron emission tomography/magnetic resonance imaging Prostate cancer Focal therapy High-intensity focused ultrasound Cryotherapy

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Immunotherapy combinations and chemotherapy sparing schemes in first line non-small cell lung cancer

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World Journal of Clinical Oncology 2021年第12期12卷 1182-1192页

作者： María Sereno Oliver Higuera Patricia Cruz Castellanos Sandra Falagan Xabier Mielgo-Rubio Juan Carlos Trujillo-Reyes felipe couñago Medical Oncology Department Hospital Universitario Infanta SofíaSan Sebastián de los Reyes 28702MadridSpain Medical Oncology Department Hospital Universitario La PazMadrid 28046Spain Medical Oncology Department Hospital Universitario Fundación AlcorcónAlcorcón 28922MadridSpain Department of Thoracic Surgery Hospital de la Santa Creu I Sant PauBarcelona 08029CataloniaSpain Department of Surgery Universitat Autonoma de BarcelonaBarcelona 08029CataloniaSpain Department of Radiation Oncology Hospital Universitario Quirónsalud MadridPozuelo de Alarcón 28223MadridSpain Department of Radiation Oncology Hospital La LuzMadrid 28003Spain Medicine Department School of Biomedical SciencesUniversidad Europea de MadridVillaviciosa de Odón 28670MadridSpain

In recent years,studies have explored different combinations of immunotherapy and *** rationale behind these is the improved survival outcomes of new immunologic therapies used in first-line-treatment of advanced non-small cell lung ***,for the most-studied combinations of anti-programed death-1(PD-1)/programed death ligand-1(PD-L1)with the addition of platinumbased chemotherapy,recent research is investigating whether combining different immunologic antitumoral mechanisms of action,such as anti-PD-1/PD-L1 and anti-CTLA-4,or anti-PD-L1 and anti-TIGIT,with or without chemotherapy,can improve efficacy outcomes compared with more classical combinations,or compared with standard chemotherapy ***,we present the data of the main randomized studies that have evaluated these combinations,focusing on the basic rationale behind the different combinations,and the efficacy and tolerability data available to date.

关键词： Immunotherapy combinations Anti-programmed cell death protein Antiprogrammed cell death ligand 1 anti-TIGIT anti-CTLA-4 Combo Non-small cell lung cancer

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Watch and wait approach in rectal cancer:Current controversies and future directions

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World Journal of Gastroenterology 2020年第29期26卷 4218-4239页

作者： Fernando López-Campos Margarita Martín-Martín Roberto Fornell-Pérez Juan Carlos García-Pérez Javier Die-Trill Raquel Fuentes-Mateos Sergio López-Durán JoséDomínguez-Rullán Reyes Ferreiro AlejandroRiquelme-Oliveira Asunción Hervás-Morón felipe couñago Department of Radiation Oncology Hospital Universitario Ramón y CajalMadrid 28034Spain Department of Radiology Hospital Universitario de BasurtoBilbao 48013VizcayaSpain Department of Surgery Hospital Universitario Ramón y CajalMadrid 28034Spain Department of Medical Oncology Hospital Universitario Ramón y CajalMadrid 28034Spain Department of Gastroenterology and Hepatology Hospital Universitario Ramón y CajalMadrid 28034Spain Department of Medical Oncology Hospital Infanta CristinaMadrid 28034Spain Department of Radiation Oncology Hospital Universitario QuirónsaludMadrid 28003Spain Department of Radiation Oncology Hospital La LuzMadrid 28003Spain Universidad Europea de Madrid(UEM) Madrid 28223Spain

According to the main international clinical guidelines,the recommended treatment for locally-advanced rectal cancer is neoadjuvant chemoradiotherapy followed by ***,doubts have been raised about the appropriate definition of clinical complete response(cCR)after neoadjuvant therapy and the role of surgery in patients who achieve a *** resection is associated with significant morbidity and decreased quality of life(QoL),which is especially relevant given the favourable prognosis in this patient subset. Accordingly, therehas been a growing interest in alternative approaches with less morbidity,including the organ-preserving watch and wait strategy, in which surgery isomitted in patients who have achieved a cCR. These patients are managed with aspecific follow-up protocol to ensure adequate cancer control, including the earlyidentification of recurrent disease. However, there are several open questionsabout this strategy, including patient selection, the clinical and radiologicalcriteria to accurately determine cCR, the duration of neoadjuvant treatment, therole of dose intensification (chemotherapy and/or radiotherapy), optimal followupprotocols, and the future perspectives of this approach. In the present review,we summarize the available evidence on the watch and wait strategy in thisclinical scenario, including ongoing clinical trials, QoL in these patients, and thecontroversies surrounding this treatment approach.

关键词： Watch and wait Rectal cancer Clinical complete response Organ preservation Dose intensification

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Deep diving in the PACIFIC:Practical issues in stage III non-small cell lung cancer to avoid shipwreck

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World Journal of Clinical Oncology 2020年第11期11卷 898-917,I0003页

作者： Xabier Mielgo-Rubio Federico Rojo Laura Mezquita-Pérez Francesc Casas Amadeo Wals Manel Juan Carlos Aguado Javier Garde-Noguera David Vicente felipe couñago Department of Medical Oncology Hospital Universitario Fundación AlcorcónMadrid 28922Spain Department of Pathology IIS-Jiménez Díaz-CIBERONC FoundationMadrid 28040Spain Department of Medical Oncology Hospital ClinicLaboratory of Translational Genomics and Targeted Therapeutics in Solid TumorsIDIBAPSBarcelona 08036Spain Department of Radiation Oncology Hospital ClinicBarcelona 08036Spain Department of Radiation Oncology Hospital Universitario Virgen MacarenaSevilla 41009Spain Department of Immunology Service Hospital ClínicUniversitat de BarcelonaBarcelona 08036Spain Department of Medical Oncology Hospital Universitario Clínico San CarlosMadrid 28040Spain Department of Medical Oncology Hospital Universitario Virgen MacarenaSevilla 49001Spain Department of Radiation Oncology Hospital Universitario Quirónsalud MadridHospital La LuzUniversidad Europea de MadridMadrid 28028Spain

After publication of the PACIFIC trial results,immune checkpoint inhibitor-based immunotherapy was included in the treatment algorithm of locally advanced non-small cell lung cancer(NSCLC).The PACIFIC trial demonstrated that 12 mo of durvalumab consolidation therapy after radical-intent platinum doublet chemotherapy with concomitant radiotherapy improved both progression-free survival and overall survival in patients with unresectable stage III *** is the first treatment in decades to successfully improve survival in this clinical setting,with manageable toxicity and without deterioration in quality of *** integration of durvalumab in the management of locally advanced NSCLC accentuates the need for multidisciplinary,coordinated decision-making among lung cancer specialists,bringing new challenges and controversies as well as important changes in clinical work *** aim of the present article is to review—from a practical,multidisciplinary perspective—the findings and implications of the PACIFIC *** evaluate the immunobiological basis of durvalumab as well as practical aspects related to programmed cell death ligand 1 *** addition,we comprehensively assess the efficacy and toxicity data from the PACIFIC trial and discuss the controversies and practical aspects of incorporating durvalumab into routine clinical ***,we discuss unresolved questions and future *** short,the present document aims to provide clinicians with a practical guide for the application of the PACIFIC regimen in routine clinical practice.

关键词： Durvalumab Non-small cell lung cancer PACIFIC Immunotherapy Immune checkpoint inhibitors Anti-programmed cell death ligand 1 Consolidation therapy Unresectable stage III lung cancer

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