Radiotherapy May Help in Node-Positive Prostate Cancer

“Adding prostate and pelvic radiotherapy (RT) to hormone therapy appears to cut relapse rates in men newly diagnosed with high-risk nonmetastatic (M0) node-positive prostate cancer, according to an exploratory analysis by European investigators.

“In a November 25 online paper in JAMA Oncology, Dr. Nicholas D. James of the University of Warwick, Coventry, UK, and colleagues note that they came to this conclusion using data collected between 2005 and 2014 in 721 patients allocated to the control arm (standard-of-care only) of the STAMPEDE Trial.

“Dr. James told Reuters Health by email that these data ‘form part of a pair of publications detailing outcomes in the control arm of STAMPEDE and help to make sense of the forthcoming paper on the randomized comparisons currently in press at The Lancet.’ “


Men Who Forgo Aggressive Treatment for Prostate Cancer Don't Receive Appropriate Monitoring

“An increasing number of men diagnosed with low-risk prostate cancer are opting for active surveillance – closely monitoring their cancer – rather than aggressive treatment to avoid the debilitating potential side effects of surgery and radiation, such as erectile and urinary dysfunction.

“However, a new study by UCLA researchers has found that less than 5 percent of men who chose to forgo aggressive treatment are being monitored as closely as they should be, putting them in danger of their cancer progressing or metastasizing without their knowledge.

“The study, published today in the peer-reviewed journal Cancer, examined the records of 37,687 men diagnosed with prostate cancer from 2004 to 2007 who were followed through 2009. They found that of the 3,656 men diagnosed with prostate cancer who did not undergo aggressive treatment, only 166 men, or 4.5 percent, were being monitored appropriately, said Dr. Karim Chamie, the study’s first author and an assistant professor of urology at UCLA.”


Yoga May Lessen Side Effects in Men Undergoing Prostate Cancer Treatment

“Men with prostate cancer who are undergoing radiation therapy can benefit from yoga, researchers at the Perelman School of Medicine at the University of Pennsylvania reported at the Society of Integrative Oncology’s 12th International Conference.

“The new, first-of-its-kind study, led by Neha Vapiwala, MD, an associate professor in the department of Radiation Oncology at PSOM and Penn’s Abramson Cancer Center, found that general quality of life and measurements of side effects often experienced by prostate —including fatigue, sexual health, and urinary incontinence—were stable throughout a course of outpatient radiation therapy among the men participating in an intensive  program.”


Shorter-Course Radiation Non-Inferior to Conventional Therapy for Low-Risk Prostate Cancer

“Hypofractionated radiation therapy yielded a similar rate of DFS and toxicity profile as conventional radiotherapy among men with low-risk prostate cancer, according to results of a randomized phase 3 non-inferiority study presented at the ASTRO Annual Meeting.

“Given in larger doses over a shorter period, hypofractionated radiation therapy is being studied as a possible improved treatment option for some patients.

“Howard Sandler, MD, MS, FASTRO, professor and chair of the department of radiation oncology at Cedars Sinai Medical Center in New York, and colleagues sought to evaluate whether the hypofractionated therapy schedule — or 70 Gy in 28 fractions over 5.6 weeks — resulted in a 5-year DFS that was not lower than that of the conventional schedule, or 73.8 Gy in 41 fractions over 8.2 weeks, by more than 7%.”


For Lung Cancer Patients, IMRT Associated with Lesser Side Effects, Better Tolerance of Chemotherapy, Compared to Conventional Radiation Therapy

“An analysis of an international, cooperative-led trial of patients with locally advanced non-small cell lung cancer (NSCLC) has shown that those who received intensity modulated radiation therapy (IMRT) had less severe lung toxicity and were able to better tolerate their chemotherapy, compared to patients who received 3-dimensional conformal radiation therapy (3-D CRT).

“Stephen Chun, M.D., fellow, Radiation Oncology at The University of Texas MD Anderson Cancer Center, presented the research at the American Society for Radiation Oncology’s 57th Annual Meeting.

“According to the American Cancer Society, in the United States, 221,200 will be diagnosed with lung cancer in 2015 and 158,040 will die from the disease — making it the deadliest of all cancers. About a third of all lung cancers are diagnosed when the cancer is locally advanced, said Chun. The standard of care for locally advanced lung cancer is concurrent chemotherapy and radiation, with most patients receiving either 3-D CRT or IMRT.”


Short-Course Palliative RT Cuts Cancer Pain

“Short-course palliative radiotherapy provided pain relief equivalent to that of conventional protocols, and allowed patients with advanced cancer to spend more time at home, investigators reported.

“Half as many patients underwent more than five treatment sessions and hospital length of stay decreased by 50% following implementation of a palliative radiation oncology service. At the same time, significantly more patients completed the planned course of radiotherapy, which resulted in a trend toward better pain relief.”


Postprostatectomy Radiation Therapy Yields Low Toxicity and Favorable Patient-Reported Quality of Life

“A prospective study of guideline-based, postoperative, image-guided intensity-modulated radiation therapy in patients with prostate cancer found low toxicity profiles and favorable patient-reported quality of life following treatment, with researchers concluding that toxicity and health-related quality of life should not impact the recommendation of radiation therapy following prostatectomy. The research was published by Berlin et al in Practical Radiation Oncology.

“Postprostatectomy radiation therapy has been reported as underutilized, with randomized trials showing the benefit of adjuvant radiation therapy, but only about 10% of patients receiving the treatment. One potential reason for underutilization could be concern over side effects or a negative impact on health-related quality of life.”


Doctors Often Overtreat with Radiation in Late-Stage Lung Cancer

“Almost half of patients with advanced lung cancer receive more than the recommended number of radiation treatments to reduce their pain, according to a new study published in the Journal of the National Cancer Institute.

“Radiation therapy that is palliative, or not intended to cure, can reduce the pain from  and improve quality of life. But unnecessary treatments add to costs and require needless trips to the hospital—and can lead to radiation toxicity and difficulty in swallowing.

“Guidelines developed from clinical trials recommend no more than 15 radiation treatments be given for pain in stage 4 . The guidelines recommend that patients not receive chemotherapy at the same time, to reduce the risk of toxicity.”


DCIS Surgery Outcomes Have Improved over Time

“Women with ductal carcinoma in situ (DCIS) treated with breast conserving surgery at Memorial Sloan Kettering Cancer Center in New York City from 1999 to 2010 had a 40% lower risk of cancer recurrence than those treated at the same institution between 1978 and 1998, a retrospective review of the prospectively maintained database has revealed.

“Five-year recurrence rates fell from 13.6% to 6.6% over these two periods and were limited to women who did not receive radiation therapy, Kimberly J. Van Zee, MD, MS, of Memorial Sloan Kettering Cancer Center reported at the American Society of Clinical Oncology (ASCO) Breast Cancer Symposium, Sept. 25-27.

” ‘Since radiation is given only to reduce local recurrence rates and has never been shown to improve survival, a woman treated currently with breast conservation without radiation can expect about a 40% lower recurrence rate than in the earlier decades,’ said Van Zee.”