Nano-drug delivery systems integrated with low radiation doses for enhanced therapeutic efficacy in cancer treatment

BACKGROUND Precision medicine is an emerging field that includes tumor-targeted delivery and tumor microenvironment.This review explores the synergistic potential of combining nano-drug delivery systems with low radiation doses to achieve optimized therapeutic outcomes,particularly in the context of cancer treatment.Nanoparticle-based drug carriers offer precise and targeted delivery,enhancing the therapeutic index of anticancer agents.The use of lower radiation doses has become a focus in radiation oncology to minimize off-target effects on healthy tissues in palliation treatment with high-target volume lesions.AIM To conduct a bibliometric review of nanomedicine and glioblastoma(GBM),all relevant studies from the last two decades were included.METHODS The search strategy comprised the keywords“nanomedicine”and“glioblastoma”in the title and/or abstract.All English-language documents from 1 January 2000 to 31 December 2023 were considered for the analysis.R code(version 4.2.0)with R Studio(version 2022.12.0-353)and the Bibliometrix package(version 4.0.1)were used for the analysis.A total of 680 documents were collected.RESULTS We analyzed the bibliometric features of nanomedicine in glioma.With the limitations of the research,our analysis aims to highlight the increasing interest of researchers in the precision medicine field in GBM treatment and lead us to suggest further studies focusing on the association between nanomedicine and radiotherapy.CONCLUSION Due to the poor prognosis associated with GBM,new therapeutic approaches are necessary.There is an increasing interest in precision medicine,which includes nanomedicine and radiotherapy,for GBM treatment.This integration enhances the efficacy of targeted treatments and provides a promising avenue for reducing adverse effects,signifying a notable advancement in precision oncology.

Treatment for paraganglioma with stereotactic radiotherapy

BACKGROUND Paragangliomas(PG)are rare neoplasms of neuroendocrine origin that tend to be highly vascularized,slow-growing,and usually sporadic.To date,common treatment options are surgical resection(SR),with or without radiation therapy(RT),and a watch-and-wait approach.AIM To evaluate the local control and effectiveness of exclusive fractionated stereotactic RT(FSRT)treatment in unresectable PG(uPG).METHODS We retrospectively evaluated patients with uPG(medically inoperable or refused SR)treated with FSRT with a Cyberknife System(Accuray Incorporated,Sunnyvale,California).Toxicity and initial efficacy were evaluated.RESULTS From May 2009 to January 2023,6 patients with a median age of 68(range 20-84)were treated with FSRT.The median delivered dose was 21 Gy(range 20-30 Gy)at a median isodose line of 75.5%(range 70%-76%)in 4 fractions(range 3-5 fractions).The median volume was 13.6 mL(range 12.4-65.24 mL).The median cumulative biological effective dose and equivalent dose in 2-Gy fractions were 70 Gy and 37.10 Gy respectively.Site of origin involved were the timpa-nojugular glomus(4/6),temporal bone,and cervical spine.In 1 of the 6 patients,the follow-up was insufficient;5 of 6 patients showed a 5-year overall survival and 5-year progression-free survival of 100%.We observed negligible toxicities during and after RT.The majority of patients showed stable symptoms during follow-up.Only 1 patient developed spine metastases.CONCLUSION Our preliminary results on this small cohort of patients suggest that FSRT could be an effective and safe alternative to SR.