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American Society for Therapeutic Radiology and Oncology, Nov. 5-9, 2006

American Society for Therapeutic Radiology and Oncology's 48th Annual Meeting

The American Society for Therapeutic Radiology and Oncology (ASTRO) held its 48th annual meeting Nov. 5 to 9 in Philadelphia and drew about 11,600 attendees from around the world. Topics ranged from basic research on breast, prostate, gynecologic, head and neck, and brain cancers to the benefits resulting from new technologies such as intensity modulated radiotherapy (IMRT).

"The topic we set for this year is topographic and biologic targeting in radiation biology," said Phillip Devlin, M.D., a radiation oncologist at the Dana-Farber Cancer Institute and Brigham and Women's Hospital, and a member of ASTRO's communications committee.

"As we've progressed from surgery alone to simple radiation and then more complex radiation, and have learned more about the genome and demographics, we have now started trying to put that all together to take cancer care right into the cell where the problem exists in the first place," Devlin said. "So we're really focusing in a very futuristic direction."

"Probably the most important study presented at the meeting had to do with radiation therapy for breast cancer," said Ken Lawrence, M.D., of the University of Michigan and immediate past chairman of ASTRO's board of directors. "Standard radiation is very well-established and effective. So now the question is: how can we make that treatment less toxic?"

During that study, Jean-Philippe Pignol, M.D., of the Sunnybrook and Women's College Health Sciences Centre in Toronto, Canada, and colleagues randomly assigned 331 women with early breast cancer to receive either IMRT or standard whole-breast radiotherapy (Abstract).

The researchers found that IMRT significantly reduced acute skin toxicity, including moist desquamation and inferior mammary fold desquamation, and caused less pain than standard radiotherapy.

"IMRT maintains the dose to the tumor bed, but permits us to give a smaller dose to the skin," Lawrence said. "This is one of the first studies to show a practical improvement."

Because IMRT is more expensive, Lawrence said, "We still need future studies to see how its benefit ranks against its cost."

Paul McGale, Ph.D., of the Clinical Trial Service Unit in the United Kingdom, presented a meta-analysis of more than 400 randomized trials that involved more than 300,000 early breast cancer patients. His research showed that post-mastectomy radiation therapy improves overall survival in node-positive patients but not in node-negative patients (Abstract).

"So that reinforces a standard practice," Devlin said.

Lawrence said an example of potentially practice-changing research was a study of 840 lung cancer patients conducted by Jean-Yves Douillard, M.D., of the Centre Rene Gauducheau in St. Herblain, France. Douillard showed that radiation therapy doubles median survival time in lung cancer patients whose cancer has spread to the mediastinal lymph nodes.

"At medical oncology meetings, there's often a tremendous buzz over a one- or two-month improvement in median survival time," Lawrence said. "In this study, the patients who just got surgery and chemotherapy had an average survival of about two years compared to four years in those who also received radiation. That's an exciting result."

Although Lawrence agreed with the authors' conclusion that the results need to be confirmed in a prospective, randomized trial, he said that the potential benefit of radiation to this group of lung cancer patients far outweighs the risk. "The side-effects from radiation are really quite modest: a temporary sore throat and very rare serious toxicities," he said. "So, overall, the extra few years that patients receive is with a very good quality of life."

ASTRO: Modulated Radiation Spares Healthy Breast Tissue

THURSDAY, Nov. 9 (HealthDay News) -- Intensity modulated radiation therapy, which allows better control of beam intensity to spare healthy tissue, reduces the risk of developing skin burns by threefold in women with breast cancer compared with conventional radiation, according to study findings presented at the annual meeting of the American Society for Therapeutic Radiology and Oncology in Philadelphia.

Abstract

ASTRO: Short-Course Radiation Acceptable for Breast Cancer

THURSDAY, Nov. 9 (HealthDay News) -- In women treated for early stage breast cancer, the usual course of six to seven weeks of external-beam radiation following lumpectomy can be safely reduced to four weeks, according to research presented this week at the annual meeting of the American Society for Therapeutic Radiology and Oncology in Philadelphia.

Abstract

ASTRO: PSA 'Bounce' Doesn't Predict Prostate Cancer Return

THURSDAY, Nov. 9 (HealthDay News) -- A temporary rise in prostate specific antigen (PSA) levels in men who undergo radiation therapy for prostate cancer does not indicate an increased risk of cancer recurrence, according to research presented this week at the annual meeting of the American Society for Therapeutic Radiology and Oncology in Philadelphia.

Abstract

ASTRO: Radiation Boost May Increase Lymphedema Risk

THURSDAY, Nov. 9 (HealthDay News) -- In women treated for early stage breast cancer, the risk of developing lymphedema may outweigh the benefit of receiving an extra boost of radiation to lymph nodes, according to research presented this week at the annual meeting of the American Society for Therapeutic Radiology and Oncology in Philadelphia.

Abstract

ASTRO: Cholesterol Screening May Benefit Hodgkin's Patients

WEDNESDAY, Nov. 8 (HealthDay News) -- In patients with Hodgkin's disease, cholesterol screening and treatment with cholesterol-lowering drugs may help extend survival, according to research presented this week at the annual meeting of the American Society for Therapeutic Radiology and Oncology in Philadelphia.

Abstract

ASTRO: Formula Helps Predict Breast Cancer Recurrence

WEDNESDAY, Nov. 8 (HealthDay News) -- A new Web-based computer tool may help doctors predict the 10-year risk of breast cancer recurrence in women who have undergone lumpectomy, according to research presented this week at the annual meeting of the American Society for Therapeutic Radiology and Oncology in Philadelphia.

Abstract

ASTRO: Radiation Beneficial After Lung Surgery, Chemo

WEDNESDAY, Nov. 8 (HealthDay News) -- In lung cancer patients whose cancer has spread to the mediastinal lymph nodes, survival is twice as long in those who receive radiation after surgery and chemotherapy than in those who do not, according to research presented this week at the annual meeting of the American Society for Therapeutic Radiology and Oncology in Philadelphia.

Abstract

ASTRO: Efficacy of Intravenous, Intra-Arterial Chemo Equal

TUESDAY, Nov. 7 (HealthDay News) -- When combined with radiation, chemotherapy given either intra-arterially directly to the tumor or intravenously are similar in terms of their ability to control cancer growth in patients with inoperable head and neck cancer, according to a study presented at the annual meeting of the American Society for Therapeutic Radiology and Oncology in Philadelphia.

Abstract

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