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.”


Radiation Tx Boosts Survival in Triple Negative Breast Ca in Older Women

“Adjuvant radiation therapy (RT) after lumpectomy for elderly women with early stage triple negative breast cancer (TNBC) improved overall survival (OS) and disease specific survival (DSS), a retrospective analysis of cases from the Surveillance, Epidemiology, and End Result (SEER) database has shown.

“The review showed that adjuvant radiation was associated with an overall six-fold decrease in any death, as well as death from breast cancer, Sean Szeja, MD, of The University of Texas Medical Branch at Galveston, and colleagues reported in a poster session at the American Society of Clinical Oncology (ASCO) Breast Cancer Symposium (Sept. 25-27).

“Some 23 months after diagnosis, 98.2% of women who received lumpectomy and radiation were alive, compared with 85.6% of those who received lumpectomy alone, the investigators said. In addition, the analysis revealed that breast cancer-related deaths were more common in the lumpectomy only group (6%) compared with the lumpectomy and radiation group (1%).”


Alternative Way to Treat Early-Stage Breast Cancer With Radiation

“Breast-cancer specialists are sharply divided over a new radiation technique that costs less and is more convenient than conventional therapy.

“The technique, known as intraoperative radiation therapy, or IORT, involves administering a single dose of radiation at the same time a patient is having lumpectomy surgery to remove a tumor. A large, randomized controlled trial concluded that IORT has fewer side effects and appears to prevent the return of cancer nearly as well as traditional treatment, in which patients undergo radiation sessions five days a week for up to seven weeks.

“Oncologists with opposing opinions have been debating that conclusion in letters and editorials in major medical journals, including the Lancet and BMJ. Some critics point out that the study found women who had IORT face twice the risk of a cancer recurrence compared with traditional radiation (3.3% versus 1.3% over five years).”


Shorter Course of Radiation Improves Quality of Life for Breast Cancer Patients

“Women who receive a shorter course of whole breast radiation therapy for early stage disease experience less toxicity and improved quality of life compared to those who undergo a longer course of treatment, researchers report from The University of Texas MD Anderson Cancer Center.

“Published in JAMA Oncology, the authors believe these findings should be communicated to women as part of the shared decision-making between breast cancer patients and their physician.

“Historically in the management of breast cancer in the U.S., radiation treatment has been given in smaller doses over a longer period of time, in a method called conventionally fractionated whole breast irradiation (CF-WBI), rather than with higher doses over a shorter period of time, or hypofractionated whole breast irradiation (HF-WBI).”


Lymph Node Radiation May Halt Breast Cancer Recurrences

“Two new studies show promising results for the use of radiation therapy to prevent breast cancer from coming back.

“The research shows that when patients with breast cancer received radiation therapy to their lymph nodes – not just the area of the breast where cancer occurred – cancer did not recur in the original site or spread to other parts of the body. Interestingly, the results were the same regardless of whether the cancer had spread to the lymph nodes.

“A group of Canadian researchers at the Juravinski Cancer Center at Hamilton Health Sciences led a study of more than 1,800 women. In a separate project, researchers at Radboud University Medical Center in the Netherlands studied more than 4,000 European women. Results were published online Wednesday in the New England Journal of Medicine.

“All of the participants had undergone a lumpectomy or a mastectomy. The studies then compared recurrence and survival data between a group of women who received radiation to their lymph nodes against those who did not.”