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Despite its clinical use and investigation in other countries, low dose radiation therapy (LDRT) in the treatment of osteoarthritis (OA) is minimally used in the United States (US). Numerous recent studies published outside the US have shown moderate to long-term pain relief and improvement of mobility after treatment with LDRT for joints affected by OA. Here, we review the most recent literature published on the use of LDRT in OA. We provide a brief outline on the epidemiology, pathophysiology, current treatments, and health care burden of OA within the US. We provide a brief history of the historic use of LDRT in the US as well as a history of LDRT within the modern era of radiation oncology, discuss criticisms of LDRT including recently published randomized trials questioning its benefit as well as the risk of secondary malignancy from LDRT, and provide an outline of treatment planning considerations and recommendations regarding dose and fractionation, energy, beam arrangements, and immobilization techniques. LDRT has been shown to be a cost-effective, noninvasive treatment with minimal side effects. Further investigation into the potential role in the treatment of OA with modern LDRT is recommended.

Purpose/Objectives To determine the utilization of and barriers to implementation of radiopharmaceutical therapy (RPT) amongst U.S. radiation oncologists. Materials/Methods An anonymous, voluntary 21-item survey directed towards attending radiation oncologists was distributed via social media platforms (Twitter, LinkedIn, Facebook, Student Doctor Network). Questions assessed practice characteristics, specific RPT prescribing patterns, RPT prescribing interest, and perceived barriers to RPT implementation. Non-parametric χ2 test was used for correlation statistics. Results Of the 142 respondents, 131 (92.3%) practiced in the U.S. and were included for this analysis. Respondents were well balanced in terms of practicing region, population size served, practice setting and years in practice. Forty-eight percent (n=63) reported prescribing at least one RPT. An additional 7% (n=8) participate in RPT administration without billing themselves. Among those that actively prescribed RPT, the mean cumulative cases per month was 4.2 (range: 1-5). The most commonly prescribed radionuclides were Radium-223 (40%; mean 2.8 cases/month), Iodine-131 (18%; mean 2.3 cases/month), Yttrium-90 (13%; mean 3.4 cases/month), “other” (8%), Samarium-153 (6%; mean 1.0 cases/month), Strontrium-89 and Phosphorous-32 (2% each; mean 1.8 and 0.4 cases/month respectively). Of those who answered “other”, Lutetium-177 dotatate was most commonly prescribed (8%). No significant (p Most radiation oncologists (56%, n=74) responded they would like to actively prescribe more RPT, while 27% (n=35) were indifferent and 17% (n=22) answered “no.” Perceived barriers to implementation were varied but broadly categorized into treatment infrastructure (44%, n=57), inter-specialty relations (41%, n=53), lack of training (23%, n=30), and financial considerations (16%, n=21). Conclusion Among surveyed U.S. radiation oncologists, a significant number reported prescribing at least one RPT. The majority expressed interest in prescribing additional RPT. Wide-ranging barriers to implementation exist, most commonly inter-specialty relations, treatment infrastructure, lack of training, and financial considerations.

Diffuse Intrinsic Pontine Glioma (DIPG) is a leading cause of death in pediatric cancer, with an abysmal Citation Format: Matthew Murray, Yazhe Wang, Ranjini K. Sundaram, Jason Beckta, W. Mark Saltzman, Ranjit S. Bindra. Exploiting mutant PPM1D-induced metabolic defects with nanoparticle-encapsulated NAMPT inhibitors [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 294.

Diffuse Intrinsic Pontine Glioma (DIPG) is a leading cause of death in pediatric cancer, with an abysmal Citation Format: Matthew A. Murray, Yazhe Wang, Ranjini Sundaram, Jason Beckta, Mark Saltzman, Ranjit Bindra. Exploiting mutant PPM1D-induced metabolic defects with nanoparticle-encapsulated NAMPT inhibitors [abstract]. In: Proceedings of the AACR-NCI-EORTC Virtual International Conference on Molecular Targets and Cancer Therapeutics; 2021 Oct 7-10. Philadelphia (PA): AACR; Mol Cancer Ther 2021;20(12 Suppl):Abstract nr P059.

Autophagy is a natural self-degradative process by which cells eliminate misfolded proteins and damaged organelles. Autophagy has been shown to have multiple functions in tumor cells that may be dependent on the tumor type and the treatment conditions. Autophagy can have a cytoprotective role and be thought of as a survival mechanism or be cytotoxic in nature and mediate cell death. Radiation, one of the primary treatments for many different types of cancer, almost uniformly promotes autophagy in tumor cells. While autophagy produced in response to radiation is often considered to be cytoprotective, radiation-induced autophagy has also been shown to mediate susceptibility to radiation. This review addresses the complexity of autophagy in response to radiation treatment in three different cancer models, specifically lung cancer, breast cancer and glioblastoma. A deeper understanding of the different roles played by autophagy in response to radiation should facilitate the development of approaches for enhancing the therapeutic utility of radiation by providing strategies for combination treatment with unique radiosensitizers as well as preventing the initiation of strategies which are likely to attenuate the effectiveness of radiation therapy., EXCLI Journal ; Vol. 13, 2014