Normal tissue reactions to radiotherapy: Towards tailoring treatment dose by genotype

A key challenge in radiotherapy is to maximize radiation doses to cancer cells while minimizing damage to surrounding healthy tissue. As severe toxicity in a minority of patients limits the doses that can be safely given to the majority, there is interest in developing a test to measure an individual’s radiosensitivity before treatment. Variation in sensitivity to radiation is an inherited genetic trait and recent progress in genotyping raises the possibility of genome-wide studies to characterize genetic profiles that predict patient response to radiotherapy

Neoplasms of the genitourinary system

Nephroblastoma or Wilms’ tumor (WT) is the most common renal neoplasm in children accounting for 90 % of pediatric renal tumors (Pastore et al. 2006). It is a tumor with a good prognosis and with well-established treatment strategies. Other rare malignant renal tumors, such as clear cell sarcoma and rhabdoid tumor of the kidney, have a poor prognosis despite aggressive treatment. Renal cell carcinoma occurs in older children, while mesoblastic nephroma is the most frequent renal tumor in the neonate. Hematological malignancies, the most frequent neoplasms in children, may also involve the kidney, most often as part of a multi-organ involvement. Renal infections and malformations are much more common in children than renal tumors and may show a pseudotumoral pattern mimicking a renal tumor. In all cases, close collaboration among radiologists, pediatricians, and pathologists is essential so as to avoid diagnostic pitfalls due to atypical presentations