ABSTRACT
New concepts of medical consultations are currently disrupting the practice of medicine. The use of standardized questionnaires, or patient-reported outcome (PRO and ePRO) has already significantly changed the relationship between the physician and the patient. Telemedicine, or even automatic conversational agents, such as chatbots, are also providing more convenient access to care and medical information for many patients. These tools have a major impact in oncology, precisely because of the rising chronicity of the diseases the radiation oncologists treat. In this article, we provide a detailed analysis of these new concepts.
Subject(s)
Neoplasms/radiotherapy , Radiation Oncology/methods , Remote Consultation , Humans , Patient Reported Outcome Measures , Surveys and QuestionnairesABSTRACT
Stereotactic radiotherapy of oligometastases, mono- or hypofractionated, represents a fundamental change in the practice of the specialty as it was developed for a century. Despite the great heterogeneity of sites, techniques, and doses, most studies found a high local control rate, around 70 to 90% at 2 years, and reduced toxicity, around 5% of grade 3 at 2 years. Four main phase II and III trials are underway in France. Future research concerns the association of stereotactic radiotherapy with immunotherapy or different conventional chemotherapy protocols, the identification of the best clinical presentations, and optimization of fractionation and biological dose for poor prognosis localizations.
Subject(s)
Clinical Trials, Phase II as Topic , Clinical Trials, Phase III as Topic , Neoplasms/radiotherapy , Radiosurgery/methods , Randomized Controlled Trials as Topic , Antibodies, Monoclonal/therapeutic use , Antineoplastic Agents, Immunological/therapeutic use , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Bone Neoplasms/radiotherapy , Bone Neoplasms/secondary , Colorectal Neoplasms/drug therapy , Colorectal Neoplasms/radiotherapy , Combined Modality Therapy/methods , Forecasting , France , Humans , Immunotherapy , Kidney Neoplasms/drug therapy , Kidney Neoplasms/radiotherapy , Lung Neoplasms/drug therapy , Lung Neoplasms/radiotherapy , Male , Neoplasm Metastasis , Neoplasms/pathology , Neoplasms/therapy , Prostatic Neoplasms/drug therapy , Prostatic Neoplasms/radiotherapy , Squamous Cell Carcinoma of Head and Neck/drug therapy , Squamous Cell Carcinoma of Head and Neck/radiotherapyABSTRACT
Stereotactic radiotherapy represents a fundamental change in the practice of radiotherapy of lung cancers. Despite the great heterogeneity of sites, techniques, and doses, most studies found a high local control rate, around 70 to 90% at 2 years, and reduced toxicity, around 5% of grade 3 at 2 years. Stereotactic radiotherapy can be realized either by a dedicated accelerator (CyberKnife®) or by a conventional accelerator associated with specific systems. The two modalities deliver a very precise irradiation whose very good results published to date are similar. Some technical characteristics specific to each type of linear accelerator could guide the choice according to the target volume treated.
