Digital Books and Challenges of Library = 电子图书与图书馆面临的挑战

Carol Bacchus (VP & Director, Life Sciences at Wiley-Blackwell) presented at the International Forum "Developments in Publishing and their Implications for Library Resource Building" (Session 2), Chinese Library Annual Conference, November 7, 2013

Personalised radiation therapy taking both the tumour and patient into consideration

A look through almost 2000 abstracts submitted for the upcoming ESTRO 2022 meeting together with a glance back on the 2021 papers published in Radiotherapy and Oncology gives one a good impression of the (current) key focus areas in radiation oncology: Almost all of this work relates to optimal delivery of radiation therapy in terms of technology, quality assurance and morbidity reducing approaches. Thus, at present the research questions considered as most relevant for radiotherapy of e.g. lung and oesophageal cancer are not related to tumour control, but to the late risk of cardiac disease in the patients who are lucky to survive their cancer long enough to develop such problems [[1]]. The same scenario is found in the patient cohort that constitutes the largest indication for radiotherapy in Europe: women with early breast cancer [[2]]. In these examples, and in many other situations where radiotherapy is applied with a curative intent, less focus has currently been given to the aim or indication of the treatment, namely the control of loco-regional malignant disease. Of course, since Holthusen’s seminal paper in 1936 [[3]] the overall aim of radiotherapy, as stated over and over again by all teachers in the field (including the authors of this editorial), is uncomplicated tumour control, i.e. loco-regional tumour control without severe normal tissue damage (therapeutic ratio). This implies that rigorous study of the effects of radiotherapy on normal, non-tumour, tissues is an absolute necessity. Yet, the prescription of radiotherapy in clinical practice is done to kill tumour cells for local and loco-regional control. If the effects of radiotherapy on tumours are shifting out of focus, it might be taken for granted that the indication, dose, fractionation, and potential multidisciplinary interactions in this field are fully understood, and what remains is the fine tuning of the associated risk of morbidity