Accelerated WBI Should be the Norm for Most Breast Cancers

Excerpt:

“Most women with breast cancer should receive accelerated whole-breast irradiation (WBI) as the standard of care, according to a new guideline from the American Society for Radiation Oncology (ASTRO).

“Accelerated, or hypofractionated, WBI is the preferred form of radiotherapy for breast cancer, regardless of a patient’s age, tumor stage, or whether the patient has received chemotherapy. The guideline replaces an ASTRO guideline published in 2011, which recommended hypofractionated WBI for selected patients: primarily older patients and those with less advanced disease.”

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Neoadjuvant Endocrine Therapy Ideal for Some Breast Cancer Patients

Excerpt:

“Endocrine therapy can achieve tumor reduction for patients with ER-positive breast cancer, possibly avoiding the need for chemotherapy or even surgery in some patients; however, deciding how long to continue this therapy can be tricky, said Hyman B. Muss, MD, who presented at the 2018 Miami Breast Cancer Conference.

” ‘It can improve the probability of breast preservation for women who would appropriately fit in [related] studies and don’t have very high-grade or aggressive tumors,’ said Muss, of the Lineberger Comprehensive Cancer Center, University of North Carolina, and a 2017 Giants of Cancer Care® winner. ‘The optimal duration is 3 to 6 months. I think it’s [also] worth considering this in postmenopausal women with larger tumors.’ ”

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Shorter Course of Treatment May Provide Better Outcome for Intermediate-Risk Prostate Cancer

Excerpt:

“Prostate cancer is the most common cancer among males in the United States. Approximately, 180,000 men are diagnosed each year, and approximately 95 percent of these men have localized disease that is potentially curable. Previously, studies have consistently demonstrated that conventionally fractionated high dose external beam radiation therapy (CRT), consisting of daily treatment for two months, decreases prostate cancer recurrence, and improves metastasis-free survival. Previous studies also demonstrate that moderate hypo-fractionated radiation therapy (HRT), consisting of daily treatment for one month using a larger dose per treatment, provides a similar low risk of recurrence, and may even be lower with HRT than CRT.”

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Intermittent Extended Letrozole Fails in Postmenopausal Breast Cancer

Excerpt:

“An intermittent dosing schedule with extended adjuvant letrozole did not improve disease-free survival (DFS) over continuous treatment with the agent in postmenopausal women with hormone receptor–positive breast cancer, according to the randomized phase III SOLE trial.

” ‘The magnitude of the beneficial effect of 5 years of extended letrozole use in postmenopausal women who have previously received an aromatase inhibitor for 5 years is low,’ wrote study authors led by Marco Colleoni, MD, of the European Institute of Oncology in Milan, Italy. That small effect may be partially due to acquired resistance, and animal studies suggest that such resistance can be reversed by discontinuing treatment.”

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New Study Provides BRCA Mutation Carriers Guidance for When Surgery Has Greatest Impact

Excerpt:

“Of the women who carry the mutated BRCA1/2 genes, 45-65 percent will develop breast cancer, and 15-39 percent will develop ovarian cancer in their lifetimes. Many women, especially those who have experienced the death of family members to these cancers, elect to undergo preventive surgeries that can significantly increase life expectancy, but require extensive recovery time and can impact later fertility and quality-of-life. However, few guidelines exist that shed light on the optimal age to undergo these procedures, and in what sequence. A new study in the INFORMS journal Decision Analysis provides insight to help enable physicians and patients make better-informed choices.

“The study, ‘Was Angelina Jolie Right? Optimizing Cancer Prevention Strategies Among BRCA Mutation Carriers,’ was conducted by Eike Nohdurft and Stefan Spinler of the Otto Beisheim School of Management, and Elisa Long, of the UCLA Anderson School of Management.”

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Radiation Prior to Surgery Reduces Risk of Secondary Tumors in Early-Stage Breast Cancer

Excerpt:

“Moffitt Cancer Center researchers launched a first of its kind study comparing the long-term benefits of radiation therapy in women with breast cancer either before surgery (neoadjuvant) or after surgery (adjuvant). Their study, published in the June 30 issue of Breast Cancer Research, found that patients who have neoadjuvant radiation therapy have a significantly lower risk of developing a second primary tumor at any site.

“The majority of patients who have early stage breast cancer have surgery to remove their tumor or a complete mastectomy. Surgery is commonly followed by radiation therapy, which has been shown to increase relapse-free survival. However, in some cases, patients may require neoadjuvant radiation therapy to decrease the size of the tumor before surgery. Currently, there are no studies that have analyzed the long-term effects of neoadjuvant radiation therapy on breast cancer patients.”

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Further Reductions in Radiotherapy to Young Children With Brain Tumors Less Successful

Excerpt:

“A team of investigators has determined that young children participating in a clinical trial to assess the effectiveness of reduced radiotherapy did worse when there were deviations from the treatment protocol. Results of the study will be available online in advance of publication by Pediatric Blood & Cancer on April 4.

” ‘This study shows that attention to the timing, dose, and location of radiation therapy is crucial,’ Kenneth K. Wong, MD, a radiation oncologist at Children’s Hospital Los Angeles and first author on the study.

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Encouraging Results for Patients with Aggressive Brain Cancer

Excerpt:

“Being diagnosed with a malignant brain tumor is devastating news for patients and their loved ones. Whereas some types of tumor respond well to treatment, others such as glioblastomas – the most common and aggressive brain tumors – are known to recur and progress within short times from the diagnosis. Patients diagnosed with this type of cancer, and who undergo current standard treatment, have a median survival of 16 months.

Based on recent information on the mechanisms of chemotherapy, a team of researchers of the McGill University Health Centre (MUHC) developed a new clinical approach to increase the efficiency of treatment in glioblastomas that increased the median survival to 22 months – bringing much needed hope to those affected by this aggressive disease. The findings of this promising phase II clinical trial have been published in the International Journal of Radiology Oncology.”

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Updated Data on SBRT Radiation for NSCLC Lung Cancer Confirm Benefits of ‘One and Done’ Approach

Excerpt:

“New research led by a radiation oncologist at Roswell Park Cancer Institute indicates that less may be more when it comes to some forms of radiation therapy for cancer. In a presentation highlighted in a plenary session today at the Multidisciplinary Thoracic Cancers Symposium in San Francisco, California, Anurag Singh, MD, shared updated evidence that patients receiving stereotactic body radiation therapy (SBRT) as treatment for non-small cell lung cancer (NSCLC) benefit as much from a single fraction, or dose, of radiation as they would from the standard three-dose treatment schedule — and with significant advantages in terms of convenience for patients and caregivers.”

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