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Advances in Radiation Therapy

  • Mekhail AnwarEmail author
  • Sean M. McBride
  • Daphne A. Haas-Kogan
Chapter
Part of the Pediatric Oncology book series (PEDIATRICO)

Abstract

Recent developments in radiation therapy have largely centered on the improvement in delivering radiation to a highly conformal target with high precision. The increased use of stereotactic body radiotherapy (SBRT) has also introduced another dimension of treatment, potentially replacing surgery in select situations to aggressive treatment of oligometastatic disease to invoking a systemic response using immunomodulators. Simultaneously, advances in systemic therapy ranging from traditional chemotherapy regimens to targeted biologics, and more recently immune modulators, are rapidly affecting the field of radiation oncology. These advances rely on a synergy between significant improvements in radiation delivery, driven by image guidances and more conformal delivery or radiation, and a greater understanding of tumor biology. This chapter will focus on an understanding of advances in these areas and future directions for pediatric brain tumors levering these innovations.

Keywords

Planning Target Volume Stereotactic Body Radiotherapy Radiation Necrosis Cranial Irradiation Boron Neutron Capture Therapy 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. Allen AM, Pawlicki T, Dong L, Fourkal E, Buyyounouski M, Cengel K, Plastaras J, Bucci MK, Yock TI, Bonilla L, Price R, Harris EE, Konski AA (2012) An evidence based review of proton beam therapy: the report of ASTRO’s emerging technology committee. Radiother Oncol 103:8–11CrossRefPubMedGoogle Scholar
  2. Anteunis LJ, Wanders SL, Hendriks JJ, Langendijk JA, Manni JJ, de Jong JM (1994) A prospective longitudinal study on radiation-induced hearing loss. Am J Surg 168:408–411CrossRefPubMedGoogle Scholar
  3. Barani IJ, Cuttino LW, Benedict SH, Todor D, Bump EA, Wu Y, Chung TD, Broaddus WC, Lin PS (2007) Neural stem cell preserving external-beam radiotherapy of central nervous system malignancies. Int J Radiat Oncol Biol Phys 68:978–985CrossRefPubMedGoogle Scholar
  4. Barker FG 2nd, Simmons ML, Chang SM, Prados MD, Larson DA, Sneed PK, Wara WM, Berger MS, Chen P, Israel MA, Aldape KD (2001) EGFR overexpression and radiation response in glioblastoma multiforme. Int J Radiat Oncol Biol Phys 51:410–418CrossRefPubMedGoogle Scholar
  5. Battermann JJ (1980) Fast neutron therapy for advanced tumors. Int J Radiat Oncol Biol Phys 6:333–335CrossRefPubMedGoogle Scholar
  6. Baumann M, Krause M, Dikomey E, Dittmann K, Dorr W, Kasten-Pisula U, Rodemann HP (2007) EGFR-targeted anti-cancer drugs in radiotherapy: preclinical evaluation of mechanisms. Radiother Oncol 83:238–248CrossRefPubMedGoogle Scholar
  7. Benedict SH, Yenice KM, Followill D, Galvin JM, Hinson W, Kavanagh B, Keall P, Lovelock M, Meeks S, Papiez L, Purdie T, Sadagopan R, Schell MC, Salter B, Schlesinger DJ, Shiu AS, Solberg T, Song DY, Stieber V, Timmerman R, Tomé WA, Verellen D, Wang L, Yin FF (2010) Stereotactic body radiation therapy: the report of AAPM Task Group 101. Med Phys 37:4078–4101CrossRefPubMedGoogle Scholar
  8. Boldrey E, Sheline G (1966) Delayed transitory clinical manifestations after radiation treatment of intracranial tumors. Acta Radiol: Ther Phys Biol 5:5–10CrossRefGoogle Scholar
  9. Bowers DC, Liu Y, Leisenring W, McNeil E, Stovall M, Gurney JG, Robison LL, Packer RJ, Oeffinger KC (2006) Late-occurring stroke among long-term survivors of childhood leukemia and brain tumors: a report from the Childhood Cancer Survivor Study. J Clin Oncol 24:5277–5282CrossRefPubMedGoogle Scholar
  10. Catteral M, Bloom HJG, Ash DV, Walsh L, Richardson A, Uttley D, Gowing NFC, Lewis P, Chaucer B (1980) Fast neutrons compared with megavoltage x-rays in the treatment of patients with supratentorial glioblastoma: a controlled pilot study. Int J Radiat Oncol Biol Phys 6:261–266CrossRefGoogle Scholar
  11. Chadha M, Capala J, Coderre JA, Elowitz EH, Iwai J-I, Joel DD, Liu HB, Wielopolski L, Chanana AD (1998) Boron neutron-capture therapy (BNCT) for glioblastoma multiforme (GBM) using the epithermal neutron beam at the Brookhaven National Laboratory. Int J Radiat Oncol Biol Phys 40:829–834CrossRefPubMedGoogle Scholar
  12. Chakraborty M, Abrams SI, Camphausen K, Liu K, Scott T, Coleman CN, Hodge JW (2003) Irradiation of tumor cells up-regulates Fas and enhances CTL lytic activity and CTL adoptive immunotherapy. J Immunol 170:6338–6347CrossRefPubMedGoogle Scholar
  13. Chakraborty M, Abrams SI, Coleman CN, Camphausen K, Schlom J, Hodge JW (2004) External beam radiation of tumors alters phenotype of tumor cells to render them susceptible to vaccine-mediated T-cell killing. Cancer Res 64:4328–4337CrossRefPubMedGoogle Scholar
  14. Copeland DR, Fletcher JM, Pfefferbaum-Levine B, Jaffe N, Ried H, Maor M (1985) Neuropsychological sequelae of childhood cancer in long-term survivors. Pediatrics 75:745–753PubMedGoogle Scholar
  15. Diaz AZ, Coderre JA, Chanana AD, Ma R (2000) Boron neutron capture therapy for malignant gliomas. Ann Med 32:81–85CrossRefPubMedGoogle Scholar
  16. Donahue B (1992) Short- and long-term complications of radiation therapy for pediatric brain tumors. Pediatr Neurosurg 18:207–217CrossRefPubMedGoogle Scholar
  17. Dong P, Lee P, Ruan D, Long T, Romeijn E, Yang Y et al (2013) 4π non-coplanar liver SBRT: a novel delivery technique. Int J Radiat Oncol Biol Phys 85(5):1360–1366CrossRefPubMedGoogle Scholar
  18. Emami B, Lyman J, Brown A, Coia L, Goitein M, Munzenrider JE, Shank B, Solin LJ, Wesson M (1991) Tolerance of normal tissue to therapeutic irradiation. Int J Radiat Oncol Biol Phys 21:109–122CrossRefPubMedGoogle Scholar
  19. Fan QW, Weiss WA (2006) Isoform specific inhibitors of PI3 kinase in glioma. Cell Cycle 5:2301–2305CrossRefPubMedGoogle Scholar
  20. Galanis E, Buckner JC, Maurer MJ, Kreisberg JI, Ballman K, Boni J, Peralba JM, Jenkins RB, Dakhil SR, Morton RF, Jaeckle KA, Scheithauer BW, Dancey J, Hidalgo M, Walsh DJ (2005) Phase II trial of temsirolimus (CCI-779) in recurrent glioblastoma multiforme: a North Central Cancer Treatment Group Study. J Clin Oncol 23:5294–5304CrossRefPubMedGoogle Scholar
  21. Gorski DH, Beckett MA, Jaskowiak NT, Calvin DP, Mauceri HJ, Salloum RM, Seetharam S, Koons A, Hari DM, Kufe DW, Weichselbaum RR (1999) Blockage of the vascular endothelial growth factor stress response increases the antitumor effects of ionizing radiation. Cancer Res 59:3374–3378PubMedGoogle Scholar
  22. Grau C, Overgaard J (1996) Postirradiation sensorineural hearing loss: a common but ignored late radiation complication. Int J Radiat Oncol Biol Phys 36:515–517CrossRefPubMedGoogle Scholar
  23. Grau C, Moller K, Overgaard M, Overgaard J, Elbrond O (1991) Sensori-neural hearing loss in patients treated with irradiation for nasopharyngeal carcinoma. Int J Radiat Oncol Biol Phys 21:723–728CrossRefPubMedGoogle Scholar
  24. Griffin TW, Davis R, Laramore G (1983) Fast neutron radiation therapy for glioblastoma multiforme–results of an RTOG study. Am J Clin Oncol 6:661–667CrossRefPubMedGoogle Scholar
  25. Gunther JR, Sato M, Chintagumpala M, Ketonen L, Jones JY, Allen PK, Paulino AC, Okcu MF, Su JM, Weinberg J, Boehling NS, Khatua S, Adesina A, Dauser R, Whitehead WE, Mahajan A (2015) Imaging changes in pediatric intracranial ependymoma patients treated with proton beam radiation therapy compared to intensity modulated radiation therapy. Int J Radiat Oncol Biol Phys 93:54–63CrossRefPubMedGoogle Scholar
  26. Gutierrez AN, Westerly DC, Tome WA, Jaradat HA, Mackie TR, Bentzen SM, Khuntia D, Mehta MP (2007) Whole brain radiotherapy with hippocampal avoidance and simultaneously integrated brain metastases boost: a planning study. Int J Radiat Oncol Biol Phys 69:589–597CrossRefPubMedPubMedCentralGoogle Scholar
  27. Halberg FE, Kramer JH, Moore IM, Wara WM, Matthay KK, Ablin AR (1992) Prophylactic cranial irradiation dose effects on late cognitive function in children treated for acute lymphoblastic leukemia. Int J Radiat Oncol Biol Phys 22:13–16CrossRefPubMedGoogle Scholar
  28. Hall EJ (2000) Radiobiology for the radiologist. Lippincott Williams & Wilkins, PhiladelphiaGoogle Scholar
  29. Hall EJ (2006) Intensity-modulated radiation therapy, protons, and the risk of second cancers. Int J Radiat Oncol Biol Phys 65:1–7CrossRefPubMedGoogle Scholar
  30. Halperin EC, Burger PC (1985) Conventional external beam radiotherapy for central nervous system malignancies. Neurol Clin 3:867–882PubMedGoogle Scholar
  31. Hermanto U, Frija EK, Lii MJ, Chang EL, Mahajan A, Woo SY (2007) Intensity-modulated radiotherapy (IMRT) and conventional three-dimensional conformal radiotherapy for high-grade gliomas: does IMRT increase the integral dose to normal brain? Int J Radiat Oncol Biol Phys 67:1135–1144CrossRefPubMedGoogle Scholar
  32. Hodgson DC, Goumnerova LC, Loeffler JS, Dutton S, Black PM, Alexander E 3rd, Xu R, Kooy H, Silver B, Tarbell NJ (2001) Radiosurgery in the management of pediatric brain tumors. Int J Radiat Oncol Biol Phys 50:929–935CrossRefPubMedGoogle Scholar
  33. Huang SM, Bock JM, Harari PM (1999) Epidermal growth factor receptor blockade with C225 modulates proliferation, apoptosis, and radiosensitivity in squamous cell carcinomas of the head and neck. Cancer Res 59:1935–1940PubMedGoogle Scholar
  34. Huang E, Teh BS, Strother DR, Davis QG, Chiu JK, Lu HH, Carpenter LS, Mai WY, Chintagumpala MM, South M, Grant WH 3rd, Butler EB, Woo SY (2002) Intensity-modulated radiation therapy for pediatric medulloblastoma: early report on the reduction of ototoxicity. Int J Radiat Oncol Biol Phys 52:599–605CrossRefPubMedGoogle Scholar
  35. Indelicato DJ, Flampouri S, Rotondo RL, Bradley JA, Morris CG, Aldana PR, Sandler E, Mendenhall NP (2014) Incidence and dosimetric parameters of pediatric brainstem toxicity following proton therapy. Acta Oncol 53:1298–1304CrossRefPubMedGoogle Scholar
  36. Jones HA, Hahn SM, Bernhard E, McKenna WG (2001) Ras inhibitors and radiation therapy. Semin Radiat Oncol 11:328–337CrossRefPubMedGoogle Scholar
  37. Kalapurakal JA, Thomas PR (1997) Pediatric radiotherapy. An overview. Radiol Clin N Am 35:1265–1280PubMedGoogle Scholar
  38. Kalapurakal JA, Goldman S, Stellpflug W, Curran J, Sathiaseelan V, Marymont MH, Tomita T (2006) Phase I study of intraoperative radiotherapy with photon radiosurgery system in children with recurrent brain tumors: preliminary report of first dose level (10 Gy). Int J Radiat Oncol Biol Phys 65:800–808CrossRefPubMedGoogle Scholar
  39. Kalbasi A et al (2013) Radiation and immunotherapy: a synergistic combination. J Clin Invest 123(7):2756CrossRefPubMedPubMedCentralGoogle Scholar
  40. Kondziolka D, Flickinger JC, Lunsford LD (2000) Stereotactic radiosurgery and radiation therapy. In: Bernstein M, Berger MS (eds) Neuro-oncology: the essentials. Thieme, New York, pp 183–197Google Scholar
  41. Kramer S, Lee KF (1974) Complications of radiation therapy: the central nervous system. Semin Roentgenol 9:75–83CrossRefPubMedGoogle Scholar
  42. Lampert H, Alegria A (1964) Treatment of post-poliomyelitis paralysis of long duration. Acta Neurol Latinoam 10:160–171PubMedGoogle Scholar
  43. Lang FF, Yung WK, Sawaya R, Tofilon PJ (1999) Adenovirus-mediated p53 gene therapy for human gliomas. Neurosurgery 45:1093–1104CrossRefPubMedGoogle Scholar
  44. Laramore GE, Diener-West M, Griffin TW, Nelson JS, Griem ML, Thomas FJ, Hendrickson FR, Griffin BR, Myrianthopoulos LC, Saxton J (1988) Randomized neutron dose searching study for malignant gliomas of the brain: results of an RTOG study. Int J Radiat Oncol Biol Phys 14:1093–1102CrossRefPubMedGoogle Scholar
  45. Lee CT, Bilton SD, Famiglietti RM, Riley BA, Mahajan A, Chang EL, Maor MH, Woo SY, Cox JD, Smith AR (2005) Treatment planning with protons for pediatric retinoblastoma, medulloblastoma, and pelvic sarcoma: how do protons compare with other conformal techniques? Int J Radiat Oncol Biol Phys 63:362–372CrossRefPubMedGoogle Scholar
  46. Littman P, Rosenstock J, Gale G, Krisch RE, Meadows A, Sather H, Coccia P, DeCamargo B (1984) The somnolence syndrome in leukemic children following reduced daily dose fractions of cranial radiation. Int J Radiat Oncol Biol Phys 10:1851–1853CrossRefPubMedGoogle Scholar
  47. Loeffler JS, Siddon RL, Wen PY, Nedzi LA, Alexander E 3rd (1990) Stereotactic radiosurgery of the brain using a standard linear accelerator: a study of early and late effects. Radiother Oncol 17:311–321CrossRefPubMedGoogle Scholar
  48. MacDonald SM, Safai S, Trofimov A, Wolfgang J, Fullerton B, Yeap BY, Bortfeld T, Tarbell NJ, Yock T (2008) Proton radiotherapy for childhood ependymoma: initial clinical outcomes and dose comparisons. Int J Radiat Oncol Biol Phys 71:979–986CrossRefPubMedGoogle Scholar
  49. Marcus KJ, Goumnerova L, Billett AL, Lavally B, Scott RM, Bishop K, Xu R, Young Poussaint T, Kieran M, Kooy H, Pomeroy SL, Tarbell NJ (2005) Stereotactic radiotherapy for localized low-grade gliomas in children: final results of a prospective trial. Int J Radiat Oncol Biol Phys 61:374–379CrossRefPubMedGoogle Scholar
  50. Mendelsohn J, Baselga J (2000) The EGF receptor family as targets for cancer therapy. Oncogene 19:6550–6565CrossRefPubMedGoogle Scholar
  51. Merchant TE, Goloubeva O, Pritchard DL, Gaber MW, Xiong X, Danish RK, Lustig RH (2002) Radiation dose-volume effects on growth hormone secretion. Int J Radiat Oncol Biol Phys 52:1264–1270CrossRefPubMedGoogle Scholar
  52. Merchant TE, Hua CH, Shukla H, Ying X, Nill S, Oelfke U (2008) Proton versus photon radiotherapy for common pediatric brain tumors: comparison of models of dose characteristics and their relationship to cognitive function. Pediatr Blood Cancer 51:110–117CrossRefPubMedGoogle Scholar
  53. Milas L, Mason K, Hunter N, Petersen S, Yamakawa M, Ang K, Mendelsohn J, Fan Z (2000) In vivo enhancement of tumor radioresponse by C225 antiepidermal growth factor receptor antibody. Clin Cancer Res 6:701–708PubMedGoogle Scholar
  54. Mitin T, Zietman AL (2014) Promise and pitfalls of heavy-particle therapy. J Clin Oncol 32:2855–2863CrossRefPubMedPubMedCentralGoogle Scholar
  55. Miyaguchi M, Takeuchi T, Morimoto K, Kubo T (1998) Correlation of epidermal growth factor receptor and radiosensitivity in human maxillary carcinoma cell lines. Acta Otolaryngol 118:428–431CrossRefPubMedGoogle Scholar
  56. Mulhern RK, Ochs J, Fairclough D (1992) Deterioration of intellect among children surviving leukemia: IQ test changes modify estimates of treatment toxicity. J Consult Clin Psychol 60:477–480CrossRefPubMedGoogle Scholar
  57. Neglia JP, Robison LL, Stovall M, Liu Y, Packer RJ, Hammond S, Yasui Y, Kasper CE, Mertens AC, Donaldson SS, Meadows AT, Inskip PD (2006) New primary neoplasms of the central nervous system in survivors of childhood cancer: a report from the Childhood Cancer Survivor Study. J Natl Cancer Inst 98:1528–1537CrossRefPubMedGoogle Scholar
  58. Nozaki M, Tada M, Kobayashi H, Zhang CL, Sawamura Y, Abe H, Ishii N, Van Meir EG (1999) Roles of the functional loss of p53 and other genes in astrocytoma tumorigenesis and progression. Neuro-Oncology 1:124–137CrossRefPubMedPubMedCentralGoogle Scholar
  59. Nyugen TD, Lassman AB, Lis E, Rosen N, Shaffer DR, Scher HI, DeAngelis LM, Abrey LE (2006) A pilot study to assess the tolerability and efficacy of RAD-001 (everolimus) with gefitinib in patients with recurrent glioblastoma multiforme (GBM). J Clin Oncol 24:1507, 2006 ASCO Annual Meeting Proceedings Part ICrossRefGoogle Scholar
  60. Pillai MR, Jayaprakash PG, Nair MK (1998) Tumour-proliferative fraction and growth factor expression as markers of tumour response to radiotherapy in cancer of the uterine cervix. J Cancer Res Clin Oncol 124:456–461CrossRefPubMedGoogle Scholar
  61. Purdy JA (1999) 3D treatment planning and intensity modulated radiation therapy. Oncology 13:155–168PubMedGoogle Scholar
  62. Rostomily RC, Halligan J, Geyer R, Stelzer K, Lindsley K, Berger MS (2001) Permanent low-activity (125)I seed placement for the treatment of pediatric brain tumors: preliminary experience. Pediatr Neurosurg 34:198–205CrossRefPubMedGoogle Scholar
  63. Rowland JH, Glidewell OJ, Sibley RF, Holland JC, Tull R, Berman A, Brecher ML, Harris M, Glicksman AS, Forman E et al (1984) Effects of different forms of central nervous system prophylaxis on neuropsychologic function in childhood leukemia. J Clin Oncol 2:1327–1335PubMedGoogle Scholar
  64. Rwigema JC, Nguyen D, Heron DE, Chen AM, Lee P, Wang PC, Vargo JA, Low DA, Huq MS, Tenn S, Steinberg ML, Kupelian P, Sheng K (2015) 4π noncoplanar stereotactic body radiation therapy for head-and-neck cancer: potential to improve tumor control and late toxicity. Int J Radiat Oncol Biol Phys 91(2):401–409CrossRefPubMedGoogle Scholar
  65. Schell MJ, McHaney VA, Green AA, Kun LE, Hayes FA, Horowitz M, Meyer WH (1989) Hearing loss in children and young adults receiving cisplatin with or without prior cranial irradiation. J Clin Oncol 7:754–760PubMedGoogle Scholar
  66. Sheridan MT, O’Dwyer T, Seymour CB, Mothersill CE (1997) Potential indicators of radiosensitivity in squamous cell carcinoma of the head and neck. Radiat Oncol Investig 5:180–186CrossRefPubMedGoogle Scholar
  67. Sneed PK, Russo C, Scharfen CO, Prados MD, Malec MK, Larson DA, Lamborn KR, Lamb SA, Voss B, Weaver KA, Phillips TL, Gutin PH, Wara WM, Edwards MS (1996) Long-term follow-up after high-activity 125I brachytherapy for pediatric brain tumors. Pediatr Neurosurg 24:314–322CrossRefPubMedGoogle Scholar
  68. St Clair WH, Adams JA, Bues M, Fullerton BC, La Shell S, Kooy HM, Loeffler JS, Tarbell NJ (2004) Advantage of protons compared to conventional X-ray or IMRT in the treatment of a pediatric patient with medulloblastoma. Int J Radiat Oncol Biol Phys 58:727–734CrossRefPubMedGoogle Scholar
  69. Syndikus I, Tait D, Ashley S, Jannoun L (1994) Long-term follow-up of young children with brain tumors after irradiation. Int J Radiat Oncol Biol Phys 30:781–787CrossRefPubMedGoogle Scholar
  70. Twyman-Saint Victor C, Rech AJ, Maity A, Rengan R, Pauken KE, Stelekati E, Benci JL, Xu B, Dada H, Odorizzi PM, Herati RS, Mansfield KD, Patsch D, Amaravadi RK, Schuchter LM, Ishwaran H, Mick R, Pryma DA, Xu X, Feldman MD, Gangadhar TC, Hahn SM, Wherry EJ, Vonderheide RH, Minn AJ (2015) Radiation and dual checkpoint blockade activate non-redundant immune mechanisms in cancer. Nature 520:373–377CrossRefPubMedGoogle Scholar
  71. Verhey LJ (1999) Comparison of three-dimensional conformal radiation therapy and intensity-modulated radiation therapy systems. Semin Radiat Oncol 9:78–98CrossRefPubMedGoogle Scholar
  72. Waber DP, Tarbell NJ, Kahn CM, Gelber RD, Sallan SE (1992) The relationship of sex and treatment modality to neuropsychologic outcome in childhood acute lymphoblastic leukemia. J Clin Oncol 10:810–817PubMedGoogle Scholar
  73. Walker DA, Pillow J, Waters KD, Keir E (1989) Enhanced cis-platinum ototoxicity in children with brain tumours who have received simultaneous or prior cranial irradiation. Med Pediatr Oncol 17:48–52CrossRefPubMedGoogle Scholar
  74. Wara WM, Phillips TL, Sheline GE, Schwade JG (1975) Radiation tolerance of the spinal cord. Cancer 35:1558–1562CrossRefPubMedGoogle Scholar
  75. Webb S (2000) Advances in three-dimensional conformal radiation therapy physics with intensity modulation. Lancet Oncol 1:30–36CrossRefPubMedGoogle Scholar
  76. Willett CG (2001) Intraoperative radiation therapy. Int J Clin Oncol 6:209–214CrossRefPubMedGoogle Scholar
  77. Wollman R, Yahalom J, Maxy R, Pinto J, Fuks Z (1994) Effect of epidermal growth factor on the growth and radiation sensitivity of human breast cancer cells in vitro. Int J Radiat Oncol Biol Phys 30:91–98CrossRefPubMedGoogle Scholar
  78. Yang TC (1999) Proton radiobiology and uncertainties. Radiat Meas 30:383–392CrossRefPubMedGoogle Scholar
  79. Yang W, Wu G, Barth RF, Swindall MR, Bandyopadhyaya AK, Tjarks W, Tordoff K, Moeschberger M, Sferra TJ, Binns PJ, Riley KJ, Ciesielski MJ, Fenstermaker RA, Wikstrand CJ (2008) Molecular targeting and treatment of composite EGFR and EGFRvIII-positive gliomas using boronated monoclonal antibodies. Clin Cancer Res 14:883–891CrossRefPubMedGoogle Scholar
  80. Zeng J M.D., See AP, Phallen J, Jackson CM, Belcaid Z, Ruzevick J, Durham N, Meyer C, Harris TJ, Albesiano E, Pradilla G, Ford E Ph.D., Wong J Ph.D., Hammers HJ, Mathios D, Tyler B, Brem H, Tran PT, Pardoll D, Drake CG, Lim M (2013) Anti-PD-1 blockade and stereotactic radiation produce long-term survival in mice with intracranial gliomas. Int J Radiat Oncol Biol Phys 86:343–349CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer International Publishing 2017

Authors and Affiliations

  • Mekhail Anwar
    • 1
    Email author
  • Sean M. McBride
    • 2
  • Daphne A. Haas-Kogan
    • 3
  1. 1.Department of Radiation OncologyUniversity of California San FranciscoSan FranciscoUSA
  2. 2.Department of Radiation OncologyMemorial Sloan Kettering Cancer CenterNew YorkUSA
  3. 3.Department of Radiation OncologyBrigham and Women’s Hospital, Dana-Farber Cancer Institute, Boston Children’s HospitalBostonUSA

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