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Non-Oncological Radiotherapy: A Review of Modern Approaches.

ABSTRACT: Despite being usually delivered in oncological patients, radiotherapy can be used as a successful treatment for several non-malignant disorders. Even though this use of radiotherapy has been scarcely investigated since the 1950s, more recent interest has actually shed the light on this approach. Thus, the aim of this narrative review is to analyze the applications of non-oncological radiotherapy in different disorders. Key references were derived from a PubMed query. Hand searching and clinicaltrials.gov were also used. This review contains a narrative report and a critical discussion of non-oncological radiotherapy approaches. In conclusion, non-oncological radiotherapy is a safe and efficacious approach to treat several disorders that needs to be further investigated and used in clinical practice.

SUBMITTER: Nardone V

PROVIDER: S-EPMC9605240 | biostudies-literature | 2022 Oct

REPOSITORIES: biostudies-literature

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Non-Oncological Radiotherapy: A Review of Modern Approaches.

Nardone Valerio V D'Ippolito Emma E Grassi Roberta R Sangiovanni Angelo A Gagliardi Federico F De Marco Giuseppina G Menditti Vittorio Salvatore VS D'Ambrosio Luca L Cioce Fabrizio F Boldrini Luca L Salvestrini Viola V Greco Carlo C Desideri Isacco I De Felice Francesca F D'Onofrio Ida I Grassi Roberto R Reginelli Alfonso A Cappabianca Salvatore S

Journal of personalized medicine 20221009 10

Despite being usually delivered in oncological patients, radiotherapy can be used as a successful treatment for several non-malignant disorders. Even though this use of radiotherapy has been scarcely investigated since the 1950s, more recent interest has actually shed the light on this approach. Thus, the aim of this narrative review is to analyze the applications of non-oncological radiotherapy in different disorders. Key references were derived from a PubMed query. Hand searching and clinicalt ...[more]

PMID: 36294816

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Project description:Background and objectiveLymphedema is a chronic, progressive disease secondary to damage to the lymphatic system that results in interstitial fluid accumulation, fat deposition and inflammation. Lymphatic surgery includes a spectrum of procedures aimed to treat these sequelae of lymphedema as well as decrease the risk of lymphedema if performed as prophylactic surgery. We reviewed the literature regarding current surgical treatment options for lymphedema, imaging approaches, and directions the field may head towards both in treatment access and techniques.MethodsWe systematically reviewed PubMed, Embase, and Cochrane Library databases to identify approaches to surgical management of lymphedema, including physiologic and reductive methods, as well as challenges that lymphedema patients face for adequate access and insurance coverage to surgical treatment options.Key content and findingsLymphatic surgery can be broadly categorized as physiologic or reductive. Physiologic lymphatic surgery functions to decrease the fluid burden associated with lymphedema and includes lymphovenous bypass as well as vascularized lymph node transplant procedures. Reductive lymphatic surgery reduces the fibroadipose component of lymphedema and include suction lipectomy and excisional procedures. Advances in imaging technology as well as supermicrosurgical techniques have allowed for reproducible, positive clinical outcomes after lymphatic procedures. Access to care and coverage of procedures are persistent challenges in the field, though increasing adoption and research have led to important strides forward to providing patients with this care.ConclusionsLymphatic surgery can improve symptoms and quality of life for lymphedema patients. A clear understanding of the predominant pathology in a patient (i.e., fluid dominant vs. fat dominant) can help guide counseling and surgical management options for patients. Despite the established benefits for patients, equitable access and insurance coverage for lymphedema surgery are still required.

Project description:IntroductionProcedural anxiety relates to an affective state of anxiety or fear in relation to a medical procedure. Various treatment-related factors may elicit anxiety among oncology patients, including fear of diagnostic imaging (such as MRI scans) and impending treatment and medical procedures (such as chemotherapy and radiotherapy). It is common in oncology settings to manage acute anxiety relating to medical procedures with anxiolytic medication. However, pharmacological approaches are not suitable for many patients. Despite this, non-pharmacological interventions are infrequently used. The aim of this systematic review is to determine whether non-pharmacological interventions delivered prior to, or during, radiotherapy are effective in reducing procedural anxiety.Methods and analysisData sources will include the bibliographic databases CINAHL, MEDLINE, EMBASE, PsycINFO and Cochrane Central Register of Controlled trials (CENTRAL) (from inception onward). Eligible studies will include adult patients with cancer undergoing radiotherapy treatment. Included studies will be those which employ a non-pharmacological intervention, delivered within existing radiotherapy appointments, with the aim of reducing procedural anxiety related to radiotherapy. All research designs with a control or other comparison group will be included. The primary outcome will be change in levels of self-reported procedural anxiety. Secondary outcomes will be changes in scores on physiological measures of anxiety and/or changes in treatment completion and/or changes in treatment duration and/or changes in psychological distress. Two investigators will independently complete title and abstract screening, full-text screening, data extraction and assessment of methodological quality. If appropriate, a meta-analyses will be performed. Any important amendments to this protocol will be updated in the PROSPERO registration and documented in the resulting review publication.Ethics and disseminationNo ethical issues are anticipated from this review. The findings will be disseminated through peer-reviewed publication and at conferences by presentation.Systematic review registrationCRD42019112941.

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Non-Oncological Radiotherapy: A Review of Modern Approaches.

Publications

Non-Oncological Radiotherapy: A Review of Modern Approaches.

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