Articles related to RADIOTHERAPY

After receiving a recently confirmed diagnosis of early-stage nodular sclerosing Hodgkin lymphoma, a 27-year-old woman is evaluated. She has not experienced weight loss, night sweats, or fever. She has an unremarkable medical history and doesn’t use any drugs. What is the best course of action after a physical examination, lab tests, and scans?

This is an 8-year follow-up to the author’s initial report of a randomized phase II study in patients with newly diagnosed primary CNS lymphoma treated with high-dose methotrexate-based induction chemotherapy followed by whole-brain radiotherapy (WBRT) or high-dose chemotherapy (thiotepa-busulfan-cyclophosphamide) with autologous stem-cell transplantation (ASCT). They conclude that 40 Gy WBRT should be avoided in first-line treatment in this population because of its neurotoxicity and suboptimal efficacy in reducing relapses, while ASCT appears to be highly efficient in preventing relapses.

The 18-month OS rates in this trial were: 66.7% for neoadjuvant mFOLFIRINOX 47.3% for neoadjuvant mFOLFIRINOX and hypofractionated radiotherapy 87.5% for mFOLFIRINOX followed by pancreatectomy 78.9% for mFOLFIRINOX plus radiotherapy followed by pancreatectomy The authors state these results “suggest that mFOLFIRINOX represents a reference neoadjuvant treatment regimen for borderline resectable pancreatic cancer; however, the role of radiotherapy in this setting remains undefined.”

The study was comprised of 17,913 men with a median age of 64 years with pT2-4N1M0 prostate cancer (PC) consecutively treated between 1995 and 2017, with postradical prostatectomy (RP) and pelvic lymph node (LN) assessment. The patients were then followed for possible treatment with adjuvant radiation therapy (aRT) or early salvage radiation therapy (sRT). It was determined that men with pN1 PC and 4 or more as compared with 1-3 positive pelvic LNs appear to benefit the most from the use of aRT.

The authors investigated the effect of adding radiotherapy to neoadjuvant chemotherapy on survival in patients with Stage III-N2 non-small cell lung cancer. Analysis included 1,175 patients diagnosed between 2004 and 2015; 799 (68.0%) underwent neoadjuvant CRT and 376 (32.0%) underwent neoadjuvant CT. Adding radiotherapy to chemotherapy showed a slightly higher median OS than chemotherapy alone (51 vs. 47 months, respectively), and a higher median CSS (75 vs. 59 months, respectively). However, these differences were not statistically significant.

Three-hundred-twenty-four (324) patients with stage II or III rectal adenocarcinoma were treated with induction chemotherapy followed by chemoradiotherapy (INCT-CRT) or chemoradiotherapy followed by consolidation chemotherapy (CRT-CNCT). Patients then underwent total mesorectal excision (TME) or were assigned to a watch-and-wait status on the basis of tumor response. Three-year TME-free survival was 41% in the INCT-CRT group and 53% in the CRT-CNCT group. Organ preservation is achievable in half of the patients with rectal cancer treated with total neoadjuvant therapy, without an apparent detriment in survival.