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Improving external beam radiotherapy by combination with internal irradiation.
A Dietrich1,2, L Koi2,3, K Zöphel1,2,4
11 German Cancer Consortium (DKTK) Dresden and German Cancer Research Center (DKFZ), Heidelberg, Germany.
The British Journal of Radiology
|March 19, 2015
Summary
Combining external beam radiotherapy (EBRT) with radioimmunotherapy (RIT) offers enhanced cancer treatment. This combination, called combined internal and external radiotherapy (CIERT), targets both bulk tumors and micrometastases, potentially improving patient outcomes.
Area of Science:
- Oncology
- Radiotherapy
- Nuclear Medicine
Background:
- External beam radiotherapy (EBRT) efficacy is dose-limited by surrounding tissue sensitivity.
- Radioimmunotherapy (RIT) offers systemic tumor targeting.
- Combining these modalities (CIERT) presents a promising strategy to overcome limitations.
Purpose of the Study:
- To review pre-clinical findings on combined internal and external radiotherapy (CIERT).
- To identify challenges and questions for clinical translation of CIERT.
- To discuss the potential of theragnostic approaches in CIERT.
Main Methods:
- Review of pre-clinical studies on CIERT.
- Analysis of toxicity profiles of combined internal and external radiotherapy.
- Discussion of theragnostic applications in CIERT.
Main Results:
- CIERT combines precise EBRT dose delivery with RIT's ability to target micrometastases.
- Toxicities of CIERT are not additive due to distinct organs at risk.
- Theragnostic pairs can predict radiotherapeutic drug uptake and identify suitable patients.
Conclusions:
- CIERT is a promising approach to enhance radiotherapy efficacy by combining EBRT and RIT.
- Further clinical investigation is needed to address challenges in implementing CIERT.
- Theragnostic tools are crucial for personalizing CIERT and predicting treatment response.
