JSCO2016: International Session 15 Radiation Therapy

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The 54th Annual Meeting of Japan Society of Clinical Oncology (JSCO2016)

"Renovation of Cancer Medicine in the Mature Society"



International Session 1: Lung Cancer
International Session 2: Colorectal Cancer
International Session 3: Gastric Cancer
International Session 4: Urological Cancer (Prostate and Renal Cancer)
International Session 5: Supportive Care for Adverse Events
International Session 6: Gynecological Cancer (Uterine Body Cancer and Ovarian Cancer)
International Session 7: Central Nervous System Tumor
International Session 8: New Development of Particle Beam Therapy for Cancer
International Session 9: International Cooperation in Radiation Medicine
International Session 10: Recent Advances In Cancer Immunotherapy
International Session 11: Breast Cancer
International Session 12: Pharmacology of Antitumor Agents: New Drug Application (NDA)
International Session 13: Malignant Lymphoma
International Session 14: Palliative Care
International Session 15: Radiation Therapy
International Session 16: Head and Neck Cancer
International Session 17: Skin Cancer (Malignant Melanoma)
International Session 18: Hepato-Biliary and Pancreas Cancers
International Session 19: Leukemia
International Session 20: Ethics for Clinical Research
International Session 21: Esophageal Cancer
International Session 22: Bone and Soft Tissue Tumor
FACO/JSCO Joint Symposium

Abstract Archives (in Japanese)

International Session 15: Radiation Therapy


Treatment guideline in Japan
Takashi Uno (Diagnostic Radiology and Radiation Oncology, Chiba University Graduate School of Medicine and School of Medicine)
Over the past 12 years, Japanese Society for Radiation Oncology (JASTRO) has developed an integrated suite of guidance to improve the quality of radiation therapy in Japan. The JASTRO Radiation Therapy Planning (RTP) Guidelines document evidence-based in addition to consensus-driven radiotherapeutic management to ensure that all patients could receive high-quality standard treatment leading to optimal outcome. The guidelines provide comprehensive up-to-date essential knowledge of radiation oncology including physics, biology, clinical practice, technical aspects of high-precision external beam radiation therapy, new concepts for target delineation and quality assurance for modern radiation therapy. Most these contents have never been well described in other organ specific clinical practice guidelines despite increasing use of radiation therapy in Japan.
In this autumn, the 4th edition of the JASTRO RTP guidelines will be published. Upcoming guidelines include following several updates; 1) Dose prescription methods for IMRT and new clinical indications for SBRT in general aspects, 2) Site specific new description such as IMRT planning for head and neck cancer, IGBT for gynecologic cancer, particle therapy for bone & soft tissue malignancies and children's cancers, and oligometastasis for palliative treatment, 3) New CTV atlas for head and neck cancer, lung cancer, esophageal cancer, breast cancer, anorectal cancer and prostate cancer, 4) Adding level of evidence for references, 5) More precise and kind explanation separated from main texts. The intent of the new JASTRO RTP guidelines is to assist in the radiotherapeutic management process of individuals involved in cancer radiotherapy, including physicians, physicists, technologists, nurses, patients and their families, with the ultimate goal of advancing radiation therapy for patients in the continuous fight against disease.


Update: Radiation oncology 2016
Jay Steven Loeffler (Radiation Oncology, Massachusetts General Hospital, USA)
The past year has shown continued progress in the field of radiation oncology. The combined modality theme with longer observation periods has shown survival gains in prostate cancer (androgen deprivation) and molecularly profiled low grade gliomas of adults (PCV chemotherapy). These RTOG studies have recently been published in the NEJM. Of interest, both studies originally demonstrated no survival gain, but with longer follow-up the improvements in survival were demonstrated - quite dramatically. Precision radiotherapy continues to be a major path forward. A recent paper in Lancet Oncology provides definitive evidence that proton therapy (versus photon therapy) reduces the late neuroendocrine and neurocognitive effects of survivors of pediatric brain tumors. However, a recent update on combined modality therapy with reduced volume and dose radiation in Hodgkin's disease continues to show alarming rates of secondary tumors. Clearly much work needs to be done. The revolution in radiation delivery technologies has allowed us to explore new treatment sites (eg liver) and has provided a therapy for the aggressive therapy with durable local control of oligometastases.


Radiotherapy in Asia: Looking back and moving forward
Miriam Joy Calaguas (South East Asian Radiation Oncology Group (SEAROG))
Asia is a heterogeneous and diverse continent having a population of 4.2 billion at present. The total incidence of cancer cases in Asia is 6.7 million (almost 48% of the global incidence). In the 2015 statistics from a survey done by the Federation of Asian Organizations in Radiation Oncology (FARO), approximately 1.6 million cancer patients per year are being treated with radiotherapy from the 11 participating Asian countries. Currently, among the radiotherapy equipment being used, there are 564 cobalt-60 teletherapy, 3405 linear accelerators (LINAC), 29 LDR and 978 HDR brachytherapy units. As the cancer burden is estimated to increase to 10.7 million in 2030, radiotherapy should meet this growing demand by improving accessibility, availability and support for these advances in technology.

Radiotherapy developed over 4 major eras: Discovery Era (1895-1925's), Orthovoltage Era (late 1920's-1950), Megavoltage Era (1950-1985) and Computer-Assisted Era (1996-2012). The future is the Ion Beams Era with the development of proton and carbon ions. These advancements in technology have the primary goal of delivering high doses of radiation in order to target the tumor while minimizing doses to the surrounding normal organs at risks.

Current trends and technological advancements in Asia include: IMRT, SRS, SBRT/SABR, IGRT, IGBT, IORT, Proton Beam Therapy and Carbon-Ion Radiotherapy. Many countries in Asia have started to use these or are already utilizing highly-advanced technologies in radiotherapy.

Therefore, radiotherapy in Asia continues to evolve in order to address the demands of the growing cancer burden. Treatment-related toxicities are important issues that need our attention. Socioeconomic factors in an ever-increasing population are adding to the complexities of the cancer problem in the region. Strategic and concrete planning is necessary in order to assure the availability of these advancements in every place in Asia.


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