radiation therapy

Study suggests that experience counts when it comes to head and neck cancer treatments

Source: medicalxpress.comAuthor: staff When it comes to specialized cancer surgery, it's generally true that the more experienced the surgeon, the better the outcome. The same might hold true for radiation therapy used to treat head and neck cancer, according to a new study led by researchers Evan Wuthrick, MD, assistant professor of radiation oncology at The Ohio State University Comprehensive Cancer Center - Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (OSUCCC - James), and Maura Gillison, MD, PhD, professor of internal medicine and epidemiology at the OSUCCC - James. Published in the Journal of Clinical Oncology with an accompanying editorial, the study compared survival and other outcomes in 470 patients treated with radiation therapy at 101 treatment centers through a clinical trial held from 2002 to 2005. The trial was sponsored by the National Cancer Institute and organized by the Radiation Therapy Oncology Group (RTOG). The findings indicated that patients treated at the less-experienced centers were more likely to have cancer recurrence (62 percent versus 42 percent at five years) and had poorer overall survival compared with those at the highly-experienced centers (51 percent versus 69 percent five-year survival, respectively). "Our findings suggest that institutional experience strongly influences outcomes in patients treated with radiation therapy for head and neck cancer," says Wuthrick, the paper's first author. "They indicate that patients do better when treated at centers where more of these procedures are performed versus centers that do fewer." Radiation therapy for head and neck cancer requires complex treatment planning that can vary considerably [...]

Charlotte Parker2014-12-09T12:06:48-07:00December, 2014|OCF In The News|

In one study, lower dose treatment for HPV oropharyngeal cancers is successful

Author: Anthony Cmelak, M.D.Source: medicalnewstoday.com A new study suggests that lowering the dose of radiation therapy for some head and neck cancer patients may improve outcomes and cause fewer long-term side effects. The research was presented by lead author Anthony Cmelak, M.D., professor of Radiation Oncology at Vanderbilt-Ingram Cancer Center (VICC), during the 50th annual meeting of the American Society of Clinical Oncology (ASCO), held recently in Chicago. The study focused on patients with newly-diagnosed oropharyngeal cancers related to the human papilloma virus (HPV). More than two-thirds of new head and neck cancer patients have HPV-positive tumors and the number of these patients is on the rise. Cmelak's prior cooperative group study found that patients with HPV-positive oropharyngeal cancer have significantly longer survival rates than patients whose tumors are HPV negative. For the new study, 80 HPV-positive patients with stage III, or IVa,b squamous cell cancer of the oropharynx received inductionchemotherapy, including paclitaxel, cisplatin and cetuximab. After chemotherapy, 62 of the patients showed no sign of cancer and were assigned to receive a 25 percent lower dose of intensity-modulated radiation therapy - an advanced technology that targets the radiation beam more accurately to treat the tumor without harming surrounding tissue. The rest of the patients received a standard IMRT dose. The drug cetuximab was also given to both groups of patients along with the IMRT treatment. Two years after treatment, the survival for the low-dose IMRT patients was 93 percent. Those who did not have complete resolution of cancer following induction and went on to [...]

Charlotte Parker2014-06-25T16:35:42-07:00June, 2014|Oral Cancer News|

Lower radiation dose may be given to HPV-positive head and neck cancer patients

Source: Vanderbilt UniversityPublished: June 19, 2014By: Dagny Stuart A new study suggests that lowering the dose of radiation therapy for some head and neck cancer patients may improve outcomes and cause fewer long-term side effects. The research was presented by lead author Anthony Cmelak, M.D., professor of Radiation Oncology at Vanderbilt-Ingram Cancer Center, during the 50th annual meeting of the American Society of Clinical Oncology (ASCO), held May 30 to June 3 in Chicago. The study focused on patients with newly diagnosed oropharyngeal cancers related to the human papilloma virus (HPV). More than two-thirds of new head and neck cancer patients have HPV-positive tumors and the number of these patients is on the rise. Cmelak’s prior study found that patients with HPV-positive oropharyngeal cancer have significantly longer survival rates than patients whose tumors are HPV negative. For the new study, 80 HPV-positive patients with stage III, or IVa,b squamous cell cancer of the oropharynx received induction chemotherapy, including paclitaxel, cisplatin and cetuximab. After chemotherapy, 62 of the patients showed no sign of cancer and were assigned to receive a 25 percent lower dose of intensity-modulated radiation therapy (IMRT) — an advanced technology that targets the radiation beam more accurately to treat the tumor without harming surrounding tissue. The rest of the patients received a standard IMRT dose. The drug cetuximab was also given to both groups of patients along with the IMRT treatment. Two years after treatment, the survival for the low-dose IMRT patients was 93 percent. Those who did [...]

Charlotte Parker2014-06-20T12:41:01-07:00June, 2014|Oral Cancer News|

Study: Recurrence of SCCOP may differ in HPV-positive and HPV-negative patients

Source: News MedicalPublished: February 21, 2014 Patients with HPV-positive squamous cell carcinoma of the oropharynx (SCCOP) had a longer time to development of distant metastasis (DM) after initial treatment, and had more metastatic sites in more atypical locations compared to HPV-negative patients, according to research presented today at the 2014 Multidisciplinary Head and Neck Cancer Symposium. Culled from records of an IRB-approved registry, the study reviewed 285 patients with stage III-IV SCCOP (originally thought to be a smoking-related head and neck cancer) treated with chemotherapy and radiation from 2002 to 2013. HPV status was determined by in situ hybridization for HPV DNA and/or by strong and diffuse (>75 percent) staining for p16 immunohistochemistry. There were 245 HPV-positive and 40 HPV-negative patients. Twenty-seven HPV-positive and eight HPV-negative patients failed with DM and were the subjects for more detailed evaluation. Radiation therapy (RT) was either 3-D RT (HPV-positive = 15/27; HPV-negative = 4/8) or intensity modulated radiation therapy (IMRT) (HPV-positive = 12/27; HPV-negative = 4/8) with doses from 66-79 Gy. Patients received concurrent chemotherapy of cisplatin (HPV-positive = 9/27; HPV-negative = 2/8), cisplatin/5 fluorouracil (FU) (HPV-positive = 10/27; HPV-negative = 3/8) or cetuximab (HPV-positive = 8/27; HPV-negative = 2/8). One HPV-negative patient received cisplatin/paclitaxel chemotherapy. One patient in each group was treated with adjuvant chemoradiotherapy after initial resection. Student t-tests were used to compare the difference between the means of the samples. Both HPV-positive and HPV-negative patients were found to have similar rates of DM, however the mean time to develop DM [...]

Charlotte Parker2014-02-24T17:27:06-07:00February, 2014|Oral Cancer News|

Are combination therapies effective for advanced SCCHN?

Source: Author: DrBicuspid Staff In a recent study, researchers from the University of North Carolina (UNC) Lineberger Comprehensive Cancer Center examined whether the addition of multiple drugs to radiation therapy is superior to the current standard of care therapy with one drug and radiation for locally advanced squamous cell carcinoma of the head and neck (SCCHN). Their data, published in the Journal of Clinical Oncology, suggests that it does not (March 4, 2013). Standard therapy for SCCHN is a combination of the drug cisplatin and radiotherapy. This clinical trial compared this combination to the combination with the addition of a small-molecule inhibitor of the epidermal growth factor receptor (EGFR) erlotinib. For the study, 204 patients with locally advanced SCCHN were recruited between December 2006 and October 2011. Participants were assigned to receive either cisplatin and radiotherapy or the same chemoradiotherapy with erlotinab. EGFR is a therapeutic target for this type of cancer, and at least one other EGFR is approved for multiple uses in treating head and neck cancer, including in combination with radiation. To date, no data have been published on the use of EGFR inhibitors in combination with chemotherapy and radiation. The goal of the current study was to determine if adding EGRF inhibition improved efficacy when combined with standard of care radiation. Unfortunately, the researchers found that the addition of EGRF did not improve clinical response rate or progression-free survival. "There has been great enthusiasm and some confusion about the combinations of chemotherapy and biologic therapy such [...]

Oral Cancer Foundation News Team - A2013-03-12T07:00:53-07:00March, 2013|Oral Cancer News|

Reirradiation for Recurrent Head and Neck Cancer

Source: Medscape News Date: November 29, 2012 Abstract Recurrence of head and neck cancer in a previously irradiated volume presents a challenging problem and has poor prognosis. A minority of patients are eligible for the preferred therapy, surgical resection. Systemic therapy is offered to patients with unresectable disease but offers little, if any, chance of cure. Repeat irradiation with systemic therapy is a potentially curative option. One randomized trial and several cooperative group and institutional studies support its use. Long-term disease-free survival has been observed, albeit with the risk of significant, possibly life threatening, late complications. Intensity-modulated radiotherapy has been shown to reduce toxicity and improve disease control. Novel systemic therapies and radiotherapy techniques, including stereotactic body radiotherapy, are under active study. Introduction Radiation therapy plays a central role in the treatment of head and neck cancer (HNC) patients. Within a treatment paradigm of functional organ preservation, evidence-based guidelines recommend radiotherapy for three quarters of all patients with HNC. [1] Both organ-preserving definitive chemoradiotherapy (CRT) and selective postoperative CRT improve locoregional recurrence (LRR) and prolong overall survival (OS). [2,3] Nevertheless, despite improvements, LRR after CRT continues to be a vexing problem for 20–35% of patients. [4–8] Even patients with favorable prognosis human papillomavirus-related HNC [9] have a LRR rate of nearly 15%. [4] Locoregional recurrence is related to a number of different factors. Some tumors are inherently radioresistant. Additionally, as radiation is delivered more precisely with smaller margins, the potential for recurrences related to 'marginal misses' has increased. Ongoing exposure [...]

Charlotte Parker2012-12-05T14:26:22-07:00December, 2012|Oral Cancer News|

CMC gets $8M to study oral damage from radiation

Source: wcnc.com by Karen Garloch / The Charlotte Observer A research team in the Department of Oral Medicine at Carolinas Medical Center has received an $8 million grant from the National Institutes of Health to study tissue damage in patients who have received high-dose radiation for head and neck cancer. Hospital officials said it is the largest research grant ever awarded to CMC. Dr. Michael Brennan, associate chairman of the oral medicine department, will be principal investigator for the Charlotte research site. Patients will also be enrolled at Harvard University, University of Pennsylvania, New York University and the University of Connecticut. Brennan said the five-year study will help doctors develop evidence-based guidelines for the care of patients’ dental health before or after radiation therapy. Patients with head and neck cancer often receive high-dose radiation therapy that results in lifelong damage to oral and facial tissues. Side effects include a decrease in saliva production, which increases the risk of tooth decay and tooth loss. Radiation can also impair bone healing, leading to an increased risk of infection around the teeth and increased risk of jaw fractures and pain that could require surgery. Patients enrolled in the study will receive a standard dental assessment prior to radiation therapy, and follow-up visits will be conducted every six months for up to two years. This news story was resourced by the Oral Cancer Foundation, and vetted for appropriateness and accuracy.

Charlotte Parker2012-09-28T09:39:10-07:00September, 2012|Oral Cancer News|

Oropharyngeal cancer patients with HPV have a more robust response to radiation therapy

Source: Eurekalert.org (SACRAMENTO, Calif.) — UC Davis cancer researchers have discovered significant differences in radiation-therapy response among patients with oropharyngeal cancer depending on whether they carry the human papillomavirus (HPV), a common sexually transmitted virus. The findings, published online today in The Laryngoscope Journal, could lead to more individualized radiation treatment regimens, which for many patients with HPV could be shorter and potentially less toxic. HPV-related cancers of the oropharynx (the region of the throat between the soft palate and the epiglottis, including the tonsils, base of tongue and uvula) have steadily increased in recent years, according to the National Cancer Institute, especially among men. At the same time, the incidence of oropharyngeal cancers related to other causes, such as smoking or alcohol consumption, is declining. HPV is the most common sexually transmitted infection in the United States; it can spread through direct skin-to-skin contact during vaginal, anal and oral sex. The UC Davis study, conducted by Allen Chen, associate professor in the UC Davis Department of Radiation Oncology, examined patterns of tumor reduction during radiation treatment in two otherwise similar groups of patients with oropharyngeal cancer: those who tested positive for HPV and those who tested negative for the virus. None of the HPV patients in the study was a smoker, a leading risk factor for the disease. Chen used CT scans acquired during image-guided radiation therapy (IGRT) and endoscopy (a tube with a small camera) to capture 3D images of the patients' tumors and monitor their treatment progress. [...]

Charlotte Parker2012-09-27T10:38:35-07:00September, 2012|Oral Cancer News|

Robots vs. radiation

Source: the-scientist.com Author: Bob Grant Scientists at London, Ontario-based Lawson Health Research Institute have launched the first ever study of the comparative effectiveness of robotic-assisted surgery versus radiation therapy for the treatment of oropharyngeal cancer, or cancer of the back of the throat. Transoral robotic surgery (TORS), a new method for removing tumors from the throat developed in 2004, approved by the US Food and Drug Administration in 2010, and already used in many hospitals in the United States, may be a good way for throat cancer patients to avoid some of radiation therapy’s side effects, which include speech problems, hearing loss, skin discoloration, taste changes, difficulty swallowing, and dry mouth. “Early studies of TORS show it holds promise to provide good disease control, as well as offer good speech and swallowing outcomes for patients,” said London Health Sciences Center (LHSC) head and neck surgeon Anthony Nichols in a statement cialis otc canadianviagras.com. “However, it is important that we conduct a thorough comparison of the two treatments.” Researchers conducting the so-called ORATOR trial will track quality of life, side effects, and survival in cancer patients randomly assigned to receive either TORS or radiation therapy. “Radiation has worked very well for the treatment of these cancers and has set a very high standard for treatment,” said LHSC radiation oncologist David Palma in a statement. “Before we can implement TORS, we need to prove that it meets that standard—are the cure rates just as good, and are the side effects [...]

Oral Cancer Foundation News Team - A2012-07-13T17:51:43-07:00July, 2012|Oral Cancer News|

Robotic Surgery Is Useful Option for Oral Cancer

Source: Onclive.com Minimally invasive transoral robotic surgery (TORS), used alone or combined with adjuvant therapy, provides good functional and oncologic outcomes in patients with oropharyngeal squamous cell carcinoma (OPSCC), new research suggests. The results were especially impressive in patients with human papillomavirus (HPV) infection, which is currently the most common cause of OPSCC in Europe and the United States. Eric J. Moore, MD, associate professor of Otolaryngology at the Mayo Clinic in Rochester, Minnesota, and coauthors reviewed a prospective database of patients with previously untreated OPSCC arising in the tonsil or base of the tongue who underwent TORS at their institution during a recent 2-year period. In 2011, about 12,000 individuals in the United States were diagnosed with OPSCC, according to the authors. The most common sites are the tonsillar fossa and base of the tongue. Customarily, OPSCC has been treated with combined modality therapy, including open surgical resection through mandibulotomy, neck dissection, and adjuvant radiation therapy or combined chemotherapy and radiation therapy. TORS was later introduced to improve access to these tumors. Functional outcomes of the study included gastrostomy tube dependence and tracheostomy dependence. Oncologic outcomes included local, regional, and distant control and disease-specific and recurrence-free survival. Overall, 66 patients who underwent TORS as their primary treatment were followed for a minimum of 2 years. Sixty-four patients, or 97%, were able to tolerate an oral diet and maintain their nutritional needs before initiating adjuvant therapy at 4 weeks. Only 3 patients, or 4.5%, required long-term gastrostomy tube use, and [...]

Charlotte Parker2012-04-30T17:14:50-07:00April, 2012|Oral Cancer News|