Radiation Oncology
RCT: Radiation therapy alone superior to chemoradiation in low-grade localized endometrial cancer recurrences
1 May, 2024 | 21:41h | UTCThis randomized clinical trial assessed the effectiveness of radiation therapy alone versus concurrent chemoradiation in treating localized recurrences of endometrial cancer. Conducted from February 2008 to August 2020, the study involved 165 patients who were randomized to receive either radiation therapy alone or chemoradiation with weekly cisplatin. Findings indicate that radiation therapy alone resulted in longer progression-free survival (PFS) compared to chemoradiation, with a median PFS not reached for radiation alone versus 73 months for chemoradiation. Additionally, radiation therapy demonstrated lower rates of acute toxicity. The study concluded that for patients with low-grade and primarily vaginal recurrences, radiation therapy alone is the preferable treatment option, offering excellent outcomes without the added toxicity of chemotherapy.
Reference (link to abstract – $ for full-text):
The Lancet Commission: Global projections and recommendations for managing the increasing burden of prostate cancer
27 Apr, 2024 | 18:42h | UTCThe Lancet Commission’s report on prostate cancer highlights the expected doubling of annual cases from 1.4 million in 2020 to 2.9 million by 2040, driven by demographic changes and increased life expectancy. This comprehensive analysis divides the issue into epidemiology, diagnostics, management of localized and advanced disease, emphasizing disparities between high-income countries (HICs) and low- and middle-income countries (LMICs). Key findings indicate that late diagnoses are common, particularly in LMICs, leading to worse outcomes. The Commission advocates for significant changes in the diagnostic pathways and increased use of current technologies tailored to available resources to improve outcomes. Education and awareness programs are recommended to facilitate early detection and shift the treatment paradigm from palliative to curative, focusing on surgery and radiotherapy. Without decisive action, the global mortality from prostate cancer is set to rise, highlighting the need for urgent interventions across all countries, with a special focus on underserved populations.
Reference:
Phase 2 RCT | Adding stereotactic body radiotherapy to immune checkpoint inhibitors fails to improve outcomes in solid tumor patients
9 Aug, 2023 | 15:28h | UTCCheckpoint Inhibitors in Combination With Stereotactic Body Radiotherapy in Patients With Advanced Solid Tumors: The CHEERS Phase 2 Randomized Clinical Trial – JAMA Oncology (link to abstract – $ for full-text)
See also: Visual Abstract
Commentary: Addition of SBRT to Immunotherapy in Advanced Solid Tumors – The ASCO Post
RCT | Upfront radiosurgery reduces tumor volume vs. a wait-and-scan approach in small- to medium-sized vestibular schwannoma
7 Aug, 2023 | 14:40h | UTCUpfront Radiosurgery vs a Wait-and-Scan Approach for Small- or Medium-Sized Vestibular Schwannoma: The V-REX Randomized Clinical Trial – JAMA (free for a limited period)
See also: Visual Abstract
Commentary on Twitter
Among patients with small or medium vestibular schwannoma, a treatment strategy consisting of upfront radiosurgery was more effective at reducing tumor volume at 4 years than was the initial wait-and-scan approach. https://t.co/Qv3YZVsq2Q pic.twitter.com/aNeu7MJfl0
— JAMA (@JAMA_current) August 2, 2023
RCT | Dysphagia-optimized intensity-modulated radiotherapy better preserves swallowing function in pharyngeal cancer patients
25 Jul, 2023 | 13:52h | UTCCommentaries:
Radiation approach improves swallowing in head, neck cancer – MDedge
Commentary on Twitter
NOW OF: The (DARS) phase 3 RCT investigates if dysphagia-optimised intensity-modulated radiotherapy (IMRT) reduces radiation dose to the dysphagia and aspiration related structures and improves swallowing function compared with standard IMRT.#hncsmhttps://t.co/CzpxsNxx1N pic.twitter.com/xNgfm43tHE
— The Lancet Oncology (@TheLancetOncol) July 7, 2023
Phase 2 Trial | The addition of immunotherapy to stereotactic ablative radiotherapy may enhance EFS in early-stage NSCLC
25 Jul, 2023 | 13:36h | UTCStereotactic ablative radiotherapy with or without immunotherapy for early-stage or isolated lung parenchymal recurrent node-negative non-small-cell lung cancer: an open-label, randomised, phase 2 trial – The Lancet (link to abstract – $ for full-text)
Systematic Review | Post-mastectomy RT likely lowers recurrence and improves survival in early breast cancer with 1-3 positive nodes
25 Jul, 2023 | 13:34h | UTC
RCT | Brachytherapy alone sufficient for intermediate-risk prostate cancer, no FFP improvement with additional EBRT
7 Jul, 2023 | 16:06h | UTCEffect of Brachytherapy With External Beam Radiation Therapy Versus Brachytherapy Alone for Intermediate-Risk Prostate Cancer: NRG Oncology RTOG 0232 Randomized Clinical Trial – Journal of Clinical Oncology (link to abstract – $ for full-text)
ESTRO-ACROP guideline | Recommendations on implementation of breath-hold techniques in radiotherapy
22 Jun, 2023 | 14:51h | UTC
RCT | Dose-escalated simultaneous integrated boost radiotherapy in early breast cancer
15 Jun, 2023 | 15:04h | UTC
M-A | Role of chemotherapy in patients with nasopharynx carcinoma treated with radiotherapy
5 Jun, 2023 | 13:29h | UTCRole of chemotherapy in patients with nasopharynx carcinoma treated with radiotherapy (MAC-NPC): an updated individual patient data network meta-analysis – The Lancet Oncology (free for a limited period)
Commentary from the author on Twitter
Our latest meta-analysis on #chemoradiation in nasopharyngeal cancer out in @TheLancetOncol
Huge collaborative work.
✅ 28 trials, 8.000+ pts, 7.6y FU
✅ more chemo (ind+conc or conc+adj) ➡️superior (OS/PFS) to CRT alone but more toxFree 50day link: https://t.co/BtRJDZERRZ pic.twitter.com/v2v5MsinnV
— Pierre Blanchard, MD (@PBlanchardMD) June 1, 2023
MASCC Guidelines for the prevention and management of acute radiation dermatitis | Part 1 – Systematic review
29 May, 2023 | 10:53h | UTCRelated:
RCT | Bacterial decolonization for prevention of radiation dermatitis
RCT | Mepitel film for the prevention of acute radiation dermatitis in breast cancer.
RCT | Bacterial decolonization for prevention of radiation dermatitis
8 May, 2023 | 12:46h | UTCBacterial Decolonization for Prevention of Radiation Dermatitis: A Randomized Clinical Trial – JAMA Oncology (free for a limited period)
News Release: A Simple Antibacterial Treatment Solves a Severe Skin Problem Caused by Radiation Therapy – Montefiore Einstein Cancer Center
Commentary on Twitter
Rand trial of 75 pts w/breast cancer + 2 with head/neck cancer showed no pts treated w/bacterial decolonization (BD) developed >gr 1 acute rad'n dermatitis (ARD), vs 24% of pts treated with standard of care, suggesting BD may be preventive vs ARD. https://t.co/6FAFH9kMt1 #RadOnc
— JAMA Oncology (@JAMAOnc) May 4, 2023
ASTRO/ESTRO Guideline | Treatment of oligometastatic non-small cell lung cancer
4 May, 2023 | 13:44h | UTC
Commentary on Twitter
ASTRO & ESTRO partnered to issue the first guideline on local therapy for oligometastatic lung cancer, out today in #PracticalRadOnc https://t.co/ZiM2RWX394 @ESTRO_RT @IyengarPuneeth @Mat_Guc pic.twitter.com/5DV3fRdn1o
— ASTRO (@ASTRO_org) April 25, 2023
AUA/SUO Guideline | Updates to Advanced Prostate Cancer
2 May, 2023 | 13:46h | UTCUpdates to Advanced Prostate Cancer: AUA/SUO Guideline (2023) – The Journal of Urology
Consensus Paper | Management of pathological thoracolumbar vertebral fractures in patients with multiple myeloma
25 Apr, 2023 | 14:11h | UTC
RCT | Stereotactic radiosurgery vs. conventional radiotherapy for localized vertebral metastases of the spine
24 Apr, 2023 | 13:37h | UTCStereotactic Radiosurgery vs Conventional Radiotherapy for Localized Vertebral Metastases of the Spine: Phase 3 Results of NRG Oncology/RTOG 0631 Randomized Clinical Trial – JAMA Oncology (link to abstract – $ for full-text)
Audio interview: Radiosurgery of Spine Metastasis—NRG/RTOG 0631 RCT Final Results – JAMA
Commentary on Twitter
Phase 3 rand trial of spinal radiosurgery vs. conventional external beam radiation therapy for pts w/spinal metastases showed radiosurgery did not significantly improve pain response at 3mo but showed feasibility that makes it widely used today. https://t.co/LvZY1nbUpS #RadOnc
— JAMA Oncology (@JAMAOnc) April 20, 2023
RCT | MRI–guided vs CT–guided stereotactic body radiotherapy for prostate cancer
18 Apr, 2023 | 12:52h | UTC
Phase 2 RCT | Addition of metastasis-directed therapy to intermittent hormone therapy for oligometastatic prostate cancer
10 Apr, 2023 | 13:41h | UTCAddition of Metastasis-Directed Therapy to Intermittent Hormone Therapy for Oligometastatic Prostate Cancer: The EXTEND Phase 2 Randomized Clinical Trial – JAMA Oncology (free for a limited period)
Commentary on Twitter
Randomized trial of intermittent hormone therapy +/- radiation to oligometastatic sites of #prostatecancer shows significantly improved PFS & assoc time off hormone therapy & w/normal testosterone from combination. https://t.co/ZnmkQuqHZm #RadOnc #PCSM #GUCSM
— JAMA Oncology (@JAMAOnc) April 6, 2023
RCT | Effects of Docetaxel as a radiosensitizer in patients with head and neck cancer, unsuitable for cisplatin-based chemoradiation
29 Mar, 2023 | 13:05h | UTCResults of Phase III Randomized Trial for Use of Docetaxel as a Radiosensitizer in Patients With Head and Neck Cancer, Unsuitable for Cisplatin-Based Chemoradiation – Journal of Clinical Oncology (link to abstract – $ for full-text)
Editorial: Good Radiosensitizer Hunting – Journal of Clinical Oncology
Commentaries:
Docetaxel Added to Radiation Provides DFS, OS Benefit in Cisplatin-Ineligible HNSCC – OncLive
RCT | Hyperfractionation vs. standard fractionation in IMRT for patients with locally advanced recurrent nasopharyngeal carcinoma
22 Mar, 2023 | 13:12h | UTCHyperfractionation compared with standard fractionation in intensity-modulated radiotherapy for patients with locally advanced recurrent nasopharyngeal carcinoma: a multicentre, randomised, open-label, phase 3 trial – The Lancet (link to abstract – $ for full-text)
RCT | Patient-reported outcomes 12 years after different treatments for localized prostate cancer
15 Mar, 2023 | 15:24h | UTCSummary: The article reports on a study that evaluated patient-reported outcomes of 1,643 participants in the ProtecT trial over a period of 7 to 12 years to assess the long-term functional and quality-of-life impacts of prostatectomy, radiotherapy with neoadjuvant androgen deprivation, and active monitoring for localized prostate cancer detected by PSA screening.
The study found that generic quality-of-life scores were similar among the randomized groups over 7 to 12 years. However, although the prostatectomy group had a lower incidence of nocturia, they showed a higher incidence of urinary incontinence and sexual dysfunction compared to the radiotherapy and active monitoring groups. The radiotherapy group had a higher incidence of fecal leakage compared to the other groups.
The study provides evidence that helps patients and their clinicians assess the trade-offs between treatment harms and benefits and make better-informed treatment decisions.
Article: Patient-Reported Outcomes 12 Years after Localized Prostate Cancer Treatment – NEJM Evidence
Original Study: RCT | Localized prostate cancer treatment options have similar 15-year survival outcomes
Dose‐escalated radiotherapy for clinically localized and locally advanced prostate cancer
14 Mar, 2023 | 13:21h | UTC
RCT | Localized prostate cancer treatment options have similar 15-year survival outcomes
13 Mar, 2023 | 15:12h | UTCSummary: The study followed 1643 men diagnosed with localized prostate cancer (diagnosed by screening with PSA) in the United Kingdom between 1999 and 2009 who were randomly assigned to receive active monitoring, prostatectomy, or radiotherapy.
After a median follow-up of 15 years, the study found that while prostatectomy and radiotherapy decreased metastasis, local progression, and the need for long-term androgen deprivation therapy, death from prostate cancer was low regardless of the treatment assigned, with 17 deaths (3.1%) in the active-monitoring group, 12 deaths (2.2%) in the prostatectomy group, and 16 (2.9%) deaths in the radiotherapy group (P=0.53). Additionally, the study found that overall deaths were similar between the groups.
The authors suggest that the choice of therapy for localized prostate cancer involves weighing the benefits and harms associated with each treatment option.
Article: Fifteen-Year Outcomes after Monitoring, Surgery, or Radiotherapy for Prostate Cancer – New England Journal of Medicine (link to abstract – $ for full-text)
News Release: Delaying treatment for localised prostate cancer does not increase mortality risk, trial shows – University of Bristol
Commentary on Twitter
Presented at #EAU23: In men with prostate cancer on PSA screening, radical treatments led to half the incidence of metastasis and local progression as active monitoring without affecting disease-specific or overall survival (ProtecT trial) https://t.co/G2ABkMkyJg #oncology pic.twitter.com/s2Va08Fpxj
— NEJM (@NEJM) March 11, 2023
RCT | Breast-conserving surgery without irradiation may be an option for older patients with early breast cancer
17 Feb, 2023 | 13:25h | UTCSummary: The article reports a phase 3 randomized trial that investigated the efficacy of omitting irradiation after breast-conserving surgery in women aged 65 years or older with hormone receptor-positive, node-negative, T1 or T2 primary breast cancer, and tumors ≤3 cm in the largest dimension, who received adjuvant endocrine therapy. A total of 1326 women were enrolled, with 658 receiving whole-breast irradiation and 668 receiving no irradiation. The results showed that the omission of radiotherapy led to an increased incidence of local breast cancer recurrence but had no negative effect on distant recurrence as the first event or overall survival. The study suggests that omission of radiotherapy could be a viable treatment option for older women with low-risk, hormone receptor–positive early breast cancer who receive adjuvant endocrine therapy.*
Article: Breast-Conserving Surgery with or without Irradiation in Early Breast Cancer – New England Journal of Medicine (link to abstract – $ for full-text)
Commentaries:
For many older breast cancer patients, study finds radiation doesn’t affect survival – STAT
Do Older Patients Need Radiation Rx After Breast Cancer Surgery? – HealthDay
*Note: This summary was created through the collaboration of a medical editor and ChatGPT.