Articles related to RADIOTHERAPY

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.

Initial results of the PREOPANC trial — comparing the addition of neoadjuvant chemoradiation therapy of gemcitabine combined plus Gy radiotherapy to standard care — failed to demonstrate a statistically significant overall survival (OS) improvement versus standard care of upfront surgery followed by adjuvant therapy. The long-term results, however, demonstrate significant benefit with neoadjuvant chemoradiation therapy consisted of gemcitabine combined plus Gy radiotherapy. The five year OS rate was 20.5% (95% CI, 14.2 to 29.8) with neoadjuvant chemoradiotherapy and 6.5% with upfront surgery.

The authors of this JCO study used a PET-adaptive approach to reduce the need for radiotherapy (RT) in early PET (-) disease and escalate therapy in patients with PET (+) disease. The study reports excellent outcomes for the approach, which allowed omission of radiotherapy in more than three-quarters of patients.

Directly from this Journal of Clinical Oncology Original Report: “Among men randomly assigned to receive ADT + RT + docetaxel versus ADT + RT, significantly less RT-induced cancers were observed. The treatment effect of adding docetaxel to ADT + RT on overall survival in men with a prostate-specific antigen (PSA) < 4 ng/mL was driven by the absence of PC death, providing evidence to support a distinct biology in low PSA-producing, unfavorable-risk PC that is docetaxel-sensitive.”

This new study found that patients who underwent radiotherapy to treat head and neck cancer experienced accelerated biological aging of as much as 4.9 years in the period immediately post therapy, with further accelerated aging following over time. The study was conducted at Emory University’s Winship Cancer Institute in Atlanta, Georgia. Chronological age is a strong risk factor for chronic health problems, including greater inflammation and fatigue.