A Century of Fractionated Radiotherapy: How Mathematical Oncology Can Break the Rules.

Radiotherapy is involved in 50% of all cancer treatments and 40% of cancer cures. Most of these treatments are delivered in fractions of equal doses of radiation (Fractional Equivalent Dosing (FED)) in days to weeks. This treatment paradigm has remained unchanged in the past century and does not account for the development of radioresistance during treatment. Even if under-optimized, deviating from a century of successful therapy delivered in FED can be difficult. One way of exploring the infinite space of fraction size and scheduling to identify optimal fractionation schedules is through mathematical oncology simulations that allow for in silico evaluation. This review article explores the evidence that current fractionation promotes the development of radioresistance, summarizes mathematical solutions to account for radioresistance, both in the curative and non-curative setting, and reviews current clinical data investigating non-FED fractionated radiotherapy.

Ida Belle Scudder and Ketayun Ardeshir Dinshaw: The two iconic women who shaped the face of radiation oncology in India.

The early twentieth century India saw profound paucity in health care delivery and education, and the beliefs of people were ruled mainly by ignorance, superstitions and myths. Diseases like cancer and its treatment were totally unknown during that time in India. Dr Ida Belle Scudder, American woman, came to India to break all norms and sacrificed her entire life to work in a missionary hospital. Gradually she trained herself to treat cancer patients and established a fully equipped radiotherapy centre to treat such patients. Later, the field of radiation oncology was transformed and modernised by another influential woman, Dr Ketayun Ardeshir Dinshaw, who with her leadership attributes left no stone unturned to firmly establish the role of radiation in the management of cancer and bringing its benefits to the people of India.

Ibtisam Lale Atahan (1946-2007): The first female Turkish physician in the discipline of radiation oncology.

Female physicians started to earn up their deserved places as late 1970's in the historically male predominant Radiation Oncology community. The first female physician emerging as a leading scientist in the Discipline of Radiation Oncology was Professor Ibtisam Lale Atahan, who untimely passed away in 2007. This eulogy attempts to shine the light on her life, achivements and legacy.

Magnetic resonance linear accelerator technology and adaptive radiation therapy: An overview for clinicians.

Radiation therapy (RT) continues to play an important role in the treatment of cancer. Adaptive RT (ART) is a novel method through which RT treatments are evolving. With the ART approach, computed tomography or magnetic resonance (MR) images are obtained as part of the treatment delivery process. This enables the adaptation of the irradiated volume to account for changes in organ and/or tumor position, movement, size, or shape that may occur over the course of treatment. The advantages and challenges of ART maybe somewhat abstract to oncologists and clinicians outside of the specialty of radiation oncology. ART is positioned to affect many different types of cancer. There is a wide spectrum of hypothesized benefits, from small toxicity improvements to meaningful gains in overall survival. The use and application of this novel technology should be understood by the oncologic community at large, such that it can be appropriately contextualized within the landscape of cancer therapies. Likewise, the need to test these advances is pressing. MR-guided ART (MRgART) is an emerging, extended modality of ART that expands upon and further advances the capabilities of ART. MRgART presents unique opportunities to iteratively improve adaptive image guidance. However, although the MRgART adaptive process advances ART to previously unattained levels, it can be more expensive, time-consuming, and complex. In this review, the authors present an overview for clinicians describing the process of ART and specifically MRgART.

Personalities and their contribution to the development of radiation oncology.

Radiotherapy is an integral part of multidisciplinary clinical oncology as one of the basic treatment modalities. Historical evolution of radiation oncology from X-ray discovery, through the discovery of radioactivity by Maria Curie-Sklodowska and her husband Pierre Curie and other worldwide scientists do not appear without the overview of eminent personalities of Czech and Slovak radiotherapy, who have deserved to develop this medical field from its beginnings to the present time.

Research-Driven Radiation Oncology: A Narrative on the Ongoing Legacy of Henry S. Kaplan.

In this rapidly evolving time of precision medicine and scientifically based cancer care, how radiation oncology became a strong research-based scientific discipline in the United States after its separation from diagnostic radiology might be lost. The importance of generational mentorship, "family trees," and interpersonal relationships can be difficult or impossible to trace absent personal narrative recollections of those involved. Henry S. Kaplan is a central figure and the focal point for 3 generations of research-based academic department chairs. This report establishes a first draft of a living record of the radiation oncology history of the Kaplan legacy to serve as an example of how knowledge networks grow and flourish and as an impetus for others to trace the legacy of other radiation oncology academic "trees."

Peggy Louise Olive: A journey through the 'comet' and beyond.

Peggy Olive from the British Columbia Cancer Research Center in Canada is credited with the development of a method to measure DNA damage in individual cells based on the technique of microelectrophoresis that she named the 'comet assay'; a well-accepted method to measure DNA damage, hypoxia and apoptosis. A multifaceted person and an ardent campaigner of environmental issues, Peggy has contributed significantly to several areas of radiobiology related to the treatment of cancer, her expertise being tumor hypoxia and gamma H2AX foci as a biomarker in radiotherapy.