The Experts below are selected from a list of 213 Experts worldwide ranked by ideXlab platform
Sashendra Senthi - One of the best experts on this subject based on the ideXlab platform.
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Pros: should a medically inoperable patient with a T2N0M0 non-small cell Lung cancer central in the Lung Hilus be treated using stereotactic body radiotherapy?
Translational lung cancer research, 2015Co-Authors: Katrina Woodford, Sashendra SenthiAbstract:The view that surgery represents the only curative treatment for non-small cell Lung cancer (NSCLC) still prevails today. Perhaps the greatest achievement of stereotactic body radiotherapy (SBRT) has been to challenge this, providing a platform to promote radiotherapy as an effective curative treatment that should be considered alongside surgery (1). The impact of this is clearest when considering populationbased outcomes from national cancer registries. In the Netherlands, the widespread implementation of SBRT has increased radiotherapy utilization, decreased the proportion of patients left untreated and as a consequence improved NSCLC survival (2). The logistic benefits of SBRT courses over conventional radiotherapy has clearly played a role in this, providing a treatment option for the elderly or those with significant comorbidities who might not otherwise be offered curative treatment. These patients represent the fastest growing population of Lung cancer patients (3) and a proportion will have central tumors for which conventional radiotherapy is infeasible. The primary argument as to whether to use SBRT for central tumors rests with maintaining population survival gains and weighing the risks of harm against those of not offering curative treatment.
José Belderbos - One of the best experts on this subject based on the ideXlab platform.
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Cons: should a medically inoperable patient with a T2N0M0 non-small cell Lung cancer central in the Lung Hilus be treated using stereotactic body radiotherapy?
Translational lung cancer research, 2015Co-Authors: Ursula Nestle, José BelderbosAbstract:Treating medically inoperable patients with T2N0 NSCLC central in the Lung Hilus by stereotactic body radiation therapy (SBRT) is a promising treatment option. Unfortunately, solid dose and volume related toxicity data are presently lacking, so that risk estimation for severe toxicities is difficult, while we simultaneously do not have evidence that such treatment would be more effective compared to conventional fractionated radiotherapy.
Katrina Woodford - One of the best experts on this subject based on the ideXlab platform.
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Pros: should a medically inoperable patient with a T2N0M0 non-small cell Lung cancer central in the Lung Hilus be treated using stereotactic body radiotherapy?
Translational lung cancer research, 2015Co-Authors: Katrina Woodford, Sashendra SenthiAbstract:The view that surgery represents the only curative treatment for non-small cell Lung cancer (NSCLC) still prevails today. Perhaps the greatest achievement of stereotactic body radiotherapy (SBRT) has been to challenge this, providing a platform to promote radiotherapy as an effective curative treatment that should be considered alongside surgery (1). The impact of this is clearest when considering populationbased outcomes from national cancer registries. In the Netherlands, the widespread implementation of SBRT has increased radiotherapy utilization, decreased the proportion of patients left untreated and as a consequence improved NSCLC survival (2). The logistic benefits of SBRT courses over conventional radiotherapy has clearly played a role in this, providing a treatment option for the elderly or those with significant comorbidities who might not otherwise be offered curative treatment. These patients represent the fastest growing population of Lung cancer patients (3) and a proportion will have central tumors for which conventional radiotherapy is infeasible. The primary argument as to whether to use SBRT for central tumors rests with maintaining population survival gains and weighing the risks of harm against those of not offering curative treatment.
Wolfgang Kummer - One of the best experts on this subject based on the ideXlab platform.
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Pulmonary Vascular Innervation and Its Role in Responses to Hypoxia
2012Co-Authors: Wolfgang KummerAbstract:The pulmonary vasculature is innervated by specific subsets of sympathetic, parasympathetic, and sensory nerve fibers. In contrast to most other organs, innervation density is highest at large-caliber vessels and decreases toward the periphery, and reactivity to vasoactive compounds also changes along the course. In some species, such as the experimentally widely used rodents rat and mouse, autonomic efferent (sympathetic and parasympathetic) perivascular axons barely reach beyond the Lung Hilus, whereas in humans this innervation extends to small intrapulmonary vessels. Throughout, the most distal arterioles (i.e., intraacinar arteries equipped with an incomplete coat of intermediate cells instead of a full muscular wall) are devoid of innervation. Altogether, 10 vasoactive substances (3 small molecular transmitters and 7 neuropeptides) at minimum have been identified in various combinations (cotransmission) in pulmonary vascular axons. Analysis of this “neurochemical coding” has been provided only for t...
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Pulmonary vascular innervation and its role in responses to hypoxia: size matters!
Proceedings of the American Thoracic Society, 2011Co-Authors: Wolfgang KummerAbstract:The pulmonary vasculature is innervated by specific subsets of sympathetic, parasympathetic, and sensory nerve fibers. In contrast to most other organs, innervation density is highest at large-caliber vessels and decreases toward the periphery, and reactivity to vasoactive compounds also changes along the course. In some species, such as the experimentally widely used rodents rat and mouse, autonomic efferent (sympathetic and parasympathetic) perivascular axons barely reach beyond the Lung Hilus, whereas in humans this innervation extends to small intrapulmonary vessels. Throughout, the most distal arterioles (i.e., intraacinar arteries equipped with an incomplete coat of intermediate cells instead of a full muscular wall) are devoid of innervation. Altogether, 10 vasoactive substances (3 small molecular transmitters and 7 neuropeptides) at minimum have been identified in various combinations (cotransmission) in pulmonary vascular axons. Analysis of this "neurochemical coding" has been provided only for the guinea pig so far, but not for humans or for animal species commonly used for pulmonary vascular research. Sympathetic pulmonary vascular neurons are reflexively activated via arterial chemoreceptors when arterial Po(2) is lowered and adapt the pulmonary vasculature to this condition of increased pulmonary blood flow by α(1)-adrenoreceptor-mediated increase in vascular impedance primarily at large vessels. In contrast, neither they nor other nerve fibers play a role in the local hypoxic vasoconstriction triggered by low alveolar Po(2), which serves to match perfusion to ventilation. The major potential role of the pulmonary vascular innervation, autonomic and sensory, lies in the pronounced trophic activities of its transmitters.
Ursula Nestle - One of the best experts on this subject based on the ideXlab platform.
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Cons: should a medically inoperable patient with a T2N0M0 non-small cell Lung cancer central in the Lung Hilus be treated using stereotactic body radiotherapy?
Translational lung cancer research, 2015Co-Authors: Ursula Nestle, José BelderbosAbstract:Treating medically inoperable patients with T2N0 NSCLC central in the Lung Hilus by stereotactic body radiation therapy (SBRT) is a promising treatment option. Unfortunately, solid dose and volume related toxicity data are presently lacking, so that risk estimation for severe toxicities is difficult, while we simultaneously do not have evidence that such treatment would be more effective compared to conventional fractionated radiotherapy.
