IMRT – Page 3 – Oral Cancer News

Advanced type of cancer radiation reduces side effects, but impact on controlling cancer is unclear

Source: www.sunherald.com Author: press release An advanced type of cancer radiation is more successful than traditional radiation in avoiding "dry mouth" when treating head and neck cancers, but it is unknown whether the treatment is better or worse at reducing the size of tumors, according to a new comparative effectiveness review funded by HHS' Agency for Healthcare Research and Quality. The report finds that intensity-modulated radiation therapy (IMRT) leads to fewer cases of xerostomia, commonly known as dry mouth, than other types of radiation. Xerostomia, a potential side effect to radiation when salivary glands are damaged, can affect basic functions like chewing, swallowing and breathing; senses such as taste, smell and hearing; and can significantly alter a patient's appearance and voice. However, the report did not find evidence that IMRT is more successful than any other kind of radiation therapy in reducing tumors. Many scientists consider IMRT to be theoretically better able to target cancerous cells while sparing healthy tissues, but more research is needed, the report said. The comparative effectiveness review, Comparative Effectiveness and Safety of Radiotherapy Treatments for Head and Neck Cancer, was authored by the Blue Cross and Blue Shield (BC/BS) Association, Technology Evaluation Center in Chicago. "The development of new technologies to treat cancer has been one of the true success stories of American medical research," said AHRQ Director Carolyn M. Clancy, M.D. "This report provides patients and their doctors with more information about these advances, which they can use to make more informed choices about [...]

Oral Cancer Foundation News Team - A2010-05-27T21:12:29-07:00May, 2010|Oral Cancer News|

Radiation planning reduces dysphagia in oropharyngeal cancer

Source: www.medscape.com Author: Nick Mulcahy In patients with oropharyngeal cancer, modifying radiotherapy to spare swallowing structures appears to be an effective strategy to reduce the long-term dysphagia that accompanies chemoradiotherapy, according to a small longitudinal study. Importantly, the strategy did not come at the expense of locoregional control, report investigators in a study published online April 26 in the Journal of Clinical Oncology. Dysphagia has emerged as perhaps the most important late adverse effect in this setting, supplanting xerostomia, said the study's senior author, Avraham Eisbruch, MD, professor of radiation oncology at the University of Michigan Medical School and Comprehensive Cancer Center in Ann Arbor. "Aggressive chemoradiotherapy approaches produce more dysphagia than in the past," he told Medscape Oncology. Meanwhile, the late adverse effect of xerostomia is on the wane, because the use of intensity-modulated radiotherapy (IMRT) has allowed radiation oncologists to spare most patients' salivary glands from radiation, he said. To address the problem of dysphagia, Dr. Eisbruch and colleagues at the University of Michigan used IMRT in combination with chemotherapy. Their treatment planning for 73 patients with stages III to IV oropharyngeal cancer included sparing any swallowing structure that did not have tumor involvement. The structures included pharyngeal constrictors, glottic and supraglottic larynx, and esophagus. One year after concurrent chemotherapy and IMRT, all 73 of the patients had either absent or minimal observer-rated dysphagia (scores, 0 to 1), with the exception of 4 people: 1 who was feeding-tube dependent and 3 who required a soft diet. The results [...]

Oral Cancer Foundation News Team - A2010-05-19T20:47:25-07:00May, 2010|Oral Cancer News|

Radiotherapy: the unsung hero of cancer care, say experts

Source: news.oneindia.in Author: staff Experts at the world's leading cancer charity have said that radiotherapy, which is a crucial cancer treatment, is often the unsung hero of cancer care. Although surgery is often the first-line of treatment and anti-cancer drugs make more headlines, radiotherapy zaps cancer cells, complements chemotherapy, relieves symptoms and shrinks tumors before surgery. In fact, four out of ten cancer patients who have beaten the disease receive the treatment at some point - and 120,000 people in the UK benefit from radiotherapy every year. But despite its benefits, it still has a slightly scary reputation, possibly because as it destroys cancer cells with a beam of high-energy rays, radiotherapy - like other cancer treatments - can also damage healthy cells. The treatment can lead to unpleasant reactions on the skin, tiredness, hair loss and mouth ulcers. But over the last 20 years huge strides have been made to improve radiotherapy and reduce these side effects. According to Cancer Research UK, decades of research into improving radiotherapy have made it more effective, sophisticated and targeted than it has ever been - and side effects have been reduced. Just last year, Dr Chris Nutting presented early results from a Cancer Research UK-funded radiotherapy trial called PARSPORT, run by The Institute of Cancer Research and The Royal Marsden Hospital. The trial tested a new cutting edge radiotherapy technique called intensity modulated radiotherapy (IMRT), as mentioned in the video above. Doctors found they were able to target the tumour more accurately [...]

Oral Cancer Foundation News Team - A2010-04-20T08:34:47-07:00April, 2010|Oral Cancer News|

Metabolic activity of head and neck cancer may help guide treatment

Source: www.oncologystat.com Author: Staff The metabolic activity of head and neck squamous cell carcinoma on pretreatment imaging independently predicts outcomes in patients who undergo intensity-modulated radiation therapy, new data show. This imaging information can be used to tailor treatment, especially to reduce the risk of distant metastases, lead investigator Dr. Min Yao said at a head and neck cancer symposium sponsored by the American Society for Radiation Oncology. Higher standardized uptake value (SUV) of the primary tumor and of the lymph nodes predicted worse outcomes in multivariate analyses presented by Dr. Yao, a radiation oncologist at the Case Western Reserve University, Cleveland. "Several papers have shown that the standardized uptake value (SUV) is a prognostic factor in head and neck cancer," Dr. Yao told attendees. Most of these studies were small series, involved patients receiving conventional radiation therapy, and did not evaluate SUV of the primary tumor and lymph nodes separately. Dr. Yao and his colleagues analyzed outcomes in 177 patients treated for head and neck squamous cell carcinoma with intensity-modulated radiation therapy (IMRT) between 1999 and 2006. The patients had a pretreatment positron emission tomography scan using fluorodeoxyglucose as the tracer (FDG-PET), and the maximal SUV was determined for both the primary tumor and the involved lymph nodes. The patients then underwent IMRT with curative intent. Seventy-seven percent of the patients were male. Twenty-nine percent were receiving IMRT postoperatively, whereas the rest were receiving it as definitive therapy. The cancer was most commonly located in the oropharynx (49%) and [...]

Oral Cancer Foundation News Team - A2010-04-18T10:24:49-07:00April, 2010|Oral Cancer News|

Metabolic activity of head and neck cancer may help guide treatment

Source: www.oncologystat.com Author: Staff The metabolic activity of head and neck squamous cell carcinoma on pretreatment imaging independently predicts outcomes in patients who undergo intensity-modulated radiation therapy, new data show. This imaging information can be used to tailor treatment, especially to reduce the risk of distant metastases, lead investigator Dr. Min Yao said at a head and neck cancer symposium sponsored by the American Society for Radiation Oncology. Higher standardized uptake value (SUV) of the primary tumor and of the lymph nodes predicted worse outcomes in multivariate analyses presented by Dr. Yao, a radiation oncologist at the Case Western Reserve University, Cleveland. "Several papers have shown that the standardized uptake value (SUV) is a prognostic factor in head and neck cancer," Dr. Yao told attendees. Most of these studies were small series, involved patients receiving conventional radiation therapy, and did not evaluate SUV of the primary tumor and lymph nodes separately. Dr. Yao and his colleagues analyzed outcomes in 177 patients treated for head and neck squamous cell carcinoma with intensity-modulated radiation therapy (IMRT) between 1999 and 2006. The patients had a pretreatment positron emission tomography scan using fluorodeoxyglucose as the tracer (FDG-PET), and the maximal SUV was determined for both the primary tumor and the involved lymph nodes. The patients then underwent IMRT with curative intent. Seventy-seven percent of the patients were male. Twenty-nine percent were receiving IMRT postoperatively, whereas the rest were receiving it as definitive therapy. The cancer was most commonly located in the oropharynx (49%) and [...]

Oral Cancer Foundation News Team - A2010-03-18T08:51:12-07:00March, 2010|Oral Cancer News|

Prolonged treatment delay did not affect outcomes in SCCHN

Source: www.hemonctoday.com Author: Christen Haigh No association was found between diagnosis to treatment interval and tumor control outcomes in patients with squamous cell carcinoma of the head and neck (SCCHN). However, patients with poor Karnofsky performance status, black patients and patients treated with intensity-modulated radiation therapy all had prolonged diagnosis to treatment interval. Jimmy J. Caudell Jr., MD, PhD, assistant professor of radiation oncology at the University of Mississippi, Jackson, presented the findings at the Multidisciplinary Head & Neck Cancer Symposium in Chandler, Ariz. Prolonged treatment delay from the time of diagnosis may often occur in patients with locoregionally advanced head and neck cancer due to social, dental, nutritional and radiotherapy planning procedures that need to be resolved prior to treatment initiation, according to researchers. To assess factors affecting treatment delay, researchers analyzed data from 426 patients with SCCHN treated with radiotherapy from 1995 to 2007 at the University of Alabama-Birmingham. The median follow-up was 42 months. The median diagnosis to treatment interval was 34 days. Longer than median diagnosis to treatment interval was associated with treatment off protocol (P=.002), black ethnicity (P=.005), insurance type (P

Oral Cancer Foundation News Team - A2010-03-05T07:32:43-07:00March, 2010|Oral Cancer News|

Radiation was the cure, and the killer

Source: nytimes.com Author: Walt Bogdanich As Scott Jerome-Parks lay dying, he clung to this wish: that his fatal radiation overdose -- which left him deaf, struggling to see, unable to swallow, burned, with his teeth falling out, with ulcers in his mouth and throat, nauseated, in severe pain and finally unable to breathe -- be studied and talked about publicly so that others might not have to live his nightmare. Sensing death was near, Jerome-Parks summoned his family for a final Christmas. His friends sent two buckets of sand from the beach where they had played as children so he could touch it, feel it and remember better days. Jerome-Parks died several weeks later in 2007. He was 43. A New York City hospital treating him for tongue cancer had failed to detect a computer error that directed a linear accelerator to blast his brain stem and neck with errant beams of radiation. Not once, but on three consecutive days. Jerome-Parks experienced the wonders and the brutality of radiation. It helped diagnose and treat his disease. It also inflicted unspeakable pain. Yet while Jerome-Parks had hoped that others might learn from his misfortune, the details of his case have until now been shielded from public view by the government, doctors and the hospital. Americans today receive far more medical radiation than ever before. The average lifetime dose of diagnostic radiation has increased sevenfold since 1980, and more than half of all cancer patients receive radiation therapy. Without a doubt, radiation [...]

Oral Cancer Foundation News Team - A2010-01-24T22:10:20-07:00January, 2010|Oral Cancer News|

Adverse events associated with concurrent chemoradiation therapy in patients with head and neck cancer

Source: Arch Otolaryngol Head Neck Surg. 2009;135(12):1209-1217 Authors: Daniel J. Givens, BS et al. Objective: To assess toxicities, functional outcomes, and health-related quality of life associated with concurrent chemoradiation therapy (CRT) in patients with head and neck cancer. Design: Prospective and retrospective outcomes study. Setting: Tertiary care institution. Patients: Participants in the longitudinal Outcomes Assessment Project whose head and neck cancer was treated with CRT between February 1, 2000, and March 1, 2007 (n = 104). Interventions: Patients prospectively provided functional and health-related quality of life information, including data from the 1-year and most current follow-up visits. Medical records were reviewed to determine toxicity and survival rates. Main Outcome Measures: Well-defined acute and late toxicities; functional outcomes (diet, dentition, tracheostomies); head and neck cancer–specific, general health, and depression outcomes; and survival rates. Results: Most patients had oropharyngeal or laryngeal tumors (87.5%) and advanced-stage disease (75.0%). Approximately one-half had hematologic toxicities and toxicity-related treatment delays. Approximately one-quarter had neurotoxicities and/or ototoxicites, moist desquamation, pneumonia, nausea and vomiting requiring hospitalization or intravenous fluids, dehydration or malnutrition requiring hospitalization, and mild or moderate fever. Although patients receiving the current intensity-modulated radiation therapy (IMRT) protocol using the Pinnacle3 planning system had more toxicity-related treatment delays, they had fewer toxicities and better functional and health-related quality of life outcomes compared with those receiving conventional lateral opposing-field radiation or the initial IMRT protocol using the Best nomos PEACOCK planning system. Conclusions: Patients receiving CRT experience a substantial number of treatment-related adverse events, primarily affecting oropharyngeal and [...]

Oral Cancer Foundation News Team - A2009-12-23T14:52:45-07:00December, 2009|Oral Cancer News|

Advances in radiation therapy enable doctors to improve the quality of treatments for patients with head and neck cancer

Source: www.prnewswire.com Author: press release Noted clinical experts detail recent developments at the annual ASTRO meeting in Chicago Clinical studies suggest that advanced treatments like intensity-modulated radiotherapy (IMRT) and image-guided radiotherapy (IGRT) are enabling radiation oncologists to enhance post-treatment health-related quality of life for patients with head and neck cancer. In an educational session for radiotherapy professionals, delivered by two noted experts during the annual meeting of the American Society for Radiation Oncology (ASTRO) in Chicago last week, Avraham Eisbruch, M.D., professor at the University of Michigan, discussed how careful implementation of IMRT in the treatment of head and neck cancer can achieve high tumor control rates while minimizing xerostomia, a dry mouth condition that occurs when salivary glands are damaged. Citing a new report summarizing results from RTOG 0022, a multi-institutional study comparing IMRT with earlier forms of treatment for head and neck cancer, Dr. Eisbruch said that IMRT for head and neck cancer achieved important goals in reducing treatment toxicity, notably xerostomia, and in yielding a high tumor control rate of 90%.(1) For patients enrolled in the study and treated with IMRT, only 55% experienced Grade 2 or worse xerostomia at six months after treatment, as compared with 84% of patients treated with earlier forms of radiotherapy -- a reduction of 35%. For the IMRT group, the percentage of patients with Grade 2 or worse xerostomia decreased steadily, to 25% at 12 months and 16% at 24 months. "This kind of improvement over time is not something we [...]

Oral Cancer Foundation News Team - A2009-11-13T13:30:22-07:00November, 2009|Oral Cancer News|

Intensity-modulated radiation offers treatment advantages over conventional therapy for head and neck cancer

Source: www.docguide.com Author: John Otrompke Patients treated with simultaneously integrated boost treatment using intensity-modulated radiation therapy (IMRT) experience better overall survival, disease-free survival, and local recurrence rates, as well as decreased dermatitis and better postoperative salivary function that those treated with conventional radiation. "IMRT treatment was described as 'boosted' because we use 2 different doses in the same patient, who gets a dose of 2.12 gy to 1 part of their anatomy, while another part gets 1.8 gy," said Sebastien Clavel, MD, University of Montreal, Montreal, Quebec, on November 3 at the American Society of Therapeutic Radiology and Oncology (ASTRO) 51st Annual Meeting. In the study, 249 patients with stage III and IV oropharyngeal carcinoma were treated between 2000 and 2007. Of these, 100 received IMRT, while 149 patients received conventional radiation therapy. After a 33-month median follow-up, 95.4% of those treated with IMRT were still alive, compared with 75.8% of those in the conventional arm. Disease-free survival was 89.3% for the IMRT group, compared with 71.6% in the conventional radiation arm. In addition, local control was 92.4% in the IMRT patients, compared with 85.3% in the conventional group. "With the old technique, the rays were shooting from both sides, whereas with IMRT, the rays come from all directions," said Dr. Clavel. "When using IMRT, we also always give them a 3-mm margin with the skin, both of which result in fewer cases of dermatitis." IMRT patients experienced a 20% decrease in dermatitis grades 3 and 4. "If we are [...]

Oral Cancer Foundation News Team - A2009-11-11T08:45:27-07:00November, 2009|Oral Cancer News|