Articles related to RADIOTHERAPY

This editorial comments on Tilki and colleagues’ “Adjuvant Versus Early Salvage Radiation Therapy After Radical Prostatectomy for pN1 Prostate Cancer and the Risk of Death.” Those researchers found that adjuvant radiotherapy (RT) was associated with a lower all-cause mortality risk compared with early salvage RT. Yet in today’s practice environment, early salvage radiotherapy (sRT) is being broadly embraced over aRT despite a continuous lack of randomized data for certain high-risk groups. The editorialist recommends that “all patients with pN1 prostate cancer—and particularly those with increasing node positivity— should be counseled on the potential survival benefits of upfront adjuvant RT demonstrated in this study and the risk that early salvage RT may not be early enough.”

In patients with NETs with distant metastasis, 90Y radioembolization (90Y RE) might be an important treatment option; however, data to support clinical benefits are scarce. The authors purposed to analyze the use of 90Y RE in NET patients with hepatic metastases in an international, multicenter retrospective analysis. In reviewing response data, they conclude that 90Y RE could be an important alternative to peptide receptor radionuclide therapy as second-line treatment in patients with progressive liver-dominant disease pretreated with somatostatin analogs.

A phase II study of durvalumab alone or combined with the anti-CD73 monoclonal antibody oleclumab or anti-NKG2A monoclonal antibody monalizumab as consolidation therapy in patients with unresectable stage III NSCLC and no progression after concurrent chemoradiotherapy. With a median follow-up of 11.5 months, both combinations increased ORR and prolonged PFS versus durvalumab alone. Safety was similar across arms with no new or significant safety signals identified with either combination.

Short-term radiotherapy with preoperative chemotherapy followed by surgery (total neoadjuvant therapy, TNT) was compared to standard long-term chemoradiotherapy in patients with locally advanced rectal cancer. At a median follow-up of 35.0 months, 3-year DFS was 64.5% and 62.3% in the TNT and CRT groups, respectively. There was no significant difference in metastasis-free survival or locoregional recurrence, but the TNT group had better 3-year overall survival than the CRT group (86.5% v 75.1%; P = .033). Treatment effects on DFS and overall survival were similar regardless of prognostic factors. The prevalence of acute grade III-V toxicities during preoperative treatment was 26.5% in the TNT group versus 12.6% in the CRT group (P < .001).

Chemoradiotherapy with high-dose cisplatin every three weeks is the standard adjuvant treatment for patients with locally advanced squamous cell carcinoma of the head and neck with high risk for recurrence. However, the cisplatin dose is frequently reduced because of dose-related toxicities which can result in insufficient cisplatin delivery. Chemoradiotherapy with weekly cisplatin at a dose of 40 mg/m2 is widely used as a possible alternative, albeit without sufficient evidence. This clinical trial was conducted to prove the noninferiority of weekly cisplatin to three weekly cisplatin plus radiation therapy (RT).

This update on the PACIFIC trial comparing durvalumab with placebo in patients with unresectable, stage III non–small-cell lung cancer demonstrated robust and sustained OS and durable PFS benefit. The updated, exploratory analyses of survival, approximately 5 years after the last patient was randomly assigned demonstrate robust and sustained OS and durable PFS benefit with durvalumab after chemoradiotherapy. An estimated 42.9% of patients randomly assigned to durvalumab remain alive at 5 years and 33.1% of patients randomly assigned to durvalumab remain alive and free of disease progression. These results establish a new benchmark for standard of care in this setting.