American Society for Radiation Oncology, Nov. 1-5, 2009
The American Society for Radiation Oncology 51st Annual Meeting took place Nov. 1 to 5 in Chicago. Over 12,000 attendees were expected to attend, including oncologists, oncology nurses, radiation therapists, biologists, physicists and other cancer researchers. Participants included both national and international experts. The theme of this year's meeting focused on radiation oncology in 2020. Breakthrough cancer research was presented through both concurrent and general sessions; educational courses were also available.
Giorgio Arcangeli, M.D., of the Regina Elena National Cancer Institute in Rome, presented evidence from a clinical study showing that hypofractionated radiation treatment was highly effective for halting prostate cancer growth in high-risk patients. Hypofractionated radiation is a novel therapy designed to deliver higher doses of radiation through fewer treatments. In this study, 168 men with high-risk prostate cancer were randomized to receive either hypofractionated or conventional radiation to the prostate and surrounding area. The study took place from January 2003 to December 2007. Patients who received hypofractionated radiation had only 20 sessions of radiation (four weeks of daily radiation therapy treatments), instead of the 40 to 45 sessions (eight to nine weeks of daily treatments) typically required during standard radiation treatment.
The study found that patients in the hypofractionated group experienced a significantly higher rate of freedom from biochemical failure compared with patients in the conventional group (87 versus 79 percent). There was no difference noted in the rate of late side effects of genitourinary or gastrointestinal function between the two treatment groups.
In a statement, Arcangeli said "the study not only shows that hypofractionated radiation improves the control of prostate cancer, but it also cuts the number of treatment visits in half for patients. This is an important benefit for these high-risk patients, who are typically an older, less mobile population." Arcangeli added, "it's also especially helpful for those living at long distance from radiation treatment centers."
Alan Pollack, M.D., of the University of Miami Miller School of Medicine, also presented results from a clinical study suggesting hypofractionation radiation therapy was an effective and safe treatment for prostate cancer patients. These data were interim results from a phase III trial which randomized 303 men with intermediate and high-risk prostate cancer to receive either hypofractionated (26 treatments over five weeks) or conventional (38 treatments over 7.5 weeks) daily radiation therapy to the prostate and surrounding area.
After a median follow-up of 39 months, the study showed no significant difference was evident in the five-year rate of biochemical failure between the hypofractionated and conventional groups (14 versus 19 percent). Additionally, there was no difference in the rates of either gastrointestinal or genitourinary toxicity.
In a statement, Pollack speculated that "the study shows that hypofractionated radiation could potentially be used in place of standard radiation therapy for intermediate and high risk prostate cancer patients, but the results are still preliminary. Although these are significant findings, longer follow-up is needed and a final analysis is planned for 2011."
James Welsh, M.D., of the M.D. Anderson Cancer Center in Houston, shared research findings which showed that obesity, not radiation dose, was the primary factor in determining if a patient with early-stage lung cancer would develop chest-wall pain following radiation therapy. Welsh reported that obese patients were over twice as likely as their non-obese counterparts to develop chronic pain after receiving stereotactic body radiation therapy to the chest wall. In addition, diabetes also appeared to play an important role, as it was shown that obese patients with diabetes were over three-fold more likely to develop chest-wall pain compared with nondiabetic patients.
"The study shows that physiological factors, such as obesity and diabetes, can play a major role in the development of radiation-related toxicity," Welsh said in a statement. "This is a surprising finding, since most side effects of radiation treatment are based on the amount of normal tissue that is treated and the volume of the dose."
Pascale Romestaing, M.D., of the Centre de Radiotherapie Mermoz in Lyon, France, presented findings from a 10-year study showing that breast cancer patients who receive post-mastectomy radiation treatment to the lymph nodes located behind the sternum do not survive longer than patients who do not receive this same radiation therapy. In this trial, 1334 women with newly diagnosed stage 1 or 2 breast cancer underwent a mastectomy followed by radiation treatment to the chest wall and supraclavicular lymph nodes. Following this, approximately half of the patients were randomized to also receive specialized internal mammary chain irradiation treatment (IMC-RT). The rates of 10-year survival for patients who did and did not receive IMC-RT were not significantly different (approximately 63 versus 60 percent).
In a statement, Romestaing concluded "this is the first study that answers the important question of whether radiation to the internal mammary chain lymph nodes benefit these patients after 10 years of follow-up. Our findings clearly show that it does not affect overall survival." Romestaing added, "these women still need radiation treatments -- just not additional radiation to these specialized cells."
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