intensity-modulated radiation therapy

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|

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|

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|

Evaluation of parotid gland function following intensity modulated radiation therapy for head and neck cancer

Source: Cancer Res Treat, April 1, 2006; 38(2): 84-91 Authors: SH Lee et al. Purpose: This study was undertaken to determine the parotid gland tolerance dose levels following intensity modulated radiation therapy (IMRT) for treating patients who suffered with head and neck cancer. Materials and Methods: From February 2003 through June 2004, 34 head and neck patients with 6 months of follow-up were evaluated for xerostomia after being treated by IMRT. Their median age was 59 years (range: 29~78). Xerostomia was assessed using a 4-question xerostomia questionnaire score (XQS) and a test for the salivary flow rates (unstimulated and stimulated: USFR and SSFR, respectively). The patients were also given a validated LENT SOMA scale (LSS) questionnaire. Evaluations were performed before IMRT and at 1, 3 and 6 months after IMRT. Results: All 34 patients showed significant changes in the XQS, LSS and Salivary Flow rates (USFR and SSFR) after IMRT. No significant changes in the XQS or LSS were noted in 12 patients who received a total parotid mean dose of 3,100 cGy, significant increases in the XQS and LSS were observed. The USFR and SSFR from the parotid glands in 7 patients who received 2,750 cGy were significantly lower than the baseline values at all times after IMRT. Conclusion: We suggest that the total parotid mean dose should be limited to

Oral Cancer Foundation News Team - A2009-09-29T21:26:45-07:00September, 2009|Oral Cancer News|

From cars to cancer: UH professor employs auto industry tools for tumor therapy

Source: www.genengnews.com Author: staff An effort is under way at the University of Houston to use technologies with origins in the automobile industry to develop new tools that will help doctors and technicians better plan radiation therapy for patients with head and neck cancer. Dr. Ali Kamrani, founding director of the Design and Free Form Fabrication Laboratory at UH and a former auto industry researcher, is teaming up with Dr. Lei Dong, associate professor and deputy research director of radiation physics at the University of Texas M.D. Anderson Cancer Center, to develop predictive models of tumors that hopefully will increase the accuracy of radiation therapy. "We aim to better understand tumor deformations using geometric and statistical models rather than repetitive CT scans," said Kamrani, an associate professor of industrial engineering at the Cullen College of Engineering. "In this case, patients will undergo a minimum number of CT scans, and the radiation plans will be developed using the predictive models." Traditional computed tomography sessions, also known as CT scans, require a large series of two-dimensional X-ray images that, when combined, provide detailed three-dimensional images of many types of tissue. "A CT scan is used to collect information with respect to tumor size, location and volume," he said. "But the CT scan itself is a source of harmful radiation to body tissues and other organs. During the treatment, patients undergo a series of CT scans, which are costly and tedious." Reducing the number of CT scans is a primary objective for Kamrani, [...]

Oral Cancer Foundation News Team - A2009-05-06T13:31:06-07:00May, 2009|Oral Cancer News|

Favourable impact of intensity-modulated radiation therapy on chronic dysphagia in patients with head and neck cancer

Source: British Journal of Radiology (2008) 81, 865-871 Authors: A. K. Anand, MD et al. The aim of this study was to evaluate the impact of intensity-modulated radiation therapy (IMRT) on the incidence and severity of chronic dysphagia in patients with head and neck cancer. 62 evaluable patients with head and neck cancer who were treated with IMRT with or without concurrent chemotherapy were analysed. The majority of the patients (77.4%) had advanced locoregional disease. 45 patients underwent definitive IMRT and 17 received post-operative IMRT. Concurrent chemotherapy was given to 29 of the 45 patients treated with definitive IMRT. The average prescribed dose to clinical target volume (CTV)1 was 66–70 Gy (definitive IMRT) and 56–62 Gy (post-operative IMRT); 60 Gy to CTV2; 54 Gy to CTV3; and 50–52 Gy to the supraclavicular area. At a median follow-up of 19 months, 2-year actuarial locoregional control and survival was 77% and 74%, respectively. At 6 months after IMRT, chronic dysphagia was Grade 0 in 77.1% of patients, Grade 1 in 10.5% and Grade 2 in 12.3%. Acute mucositis showed no correlation with long-term dysphagia. The percutaneous endoscopic gastrostomy or nasogastric tube was removed in all of the patients within 8 weeks of completion of treatment. Xerostomia was Grade 0 in 61.4% of patients, Grade 1 in 31.5% and Grade 2 in 7% of patients. In conclusion, IMRT conferred a major favourable impact on chronic dysphagia in patients with locally advanced head and neck cancers, with satisfactory locoregional control. Authors: A. K. Anand, [...]

Oral Cancer Foundation News Team - A2008-10-24T06:49:50-07:00October, 2008|Oral Cancer News|