Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Study finds more targeted form of radiation improves survival in patients with head and neck cancers

13.01.2014
IMRT reduces side effects, also improves outcomes

Patients with cancers of the head and neck who received intensity-modulated radiation therapy (IMRT) - a technology designed to more precisely target cancer cells and spare nearby tissue - experienced improved outcomes, as well as reduced toxicities, compared to patients receiving conventional radiation therapy, according to new research from The University of Texas MD Anderson Cancer Center.

The study, published in the journal Cancer, is the first to document this finding in a large population-based group, as well as the first to suggest IMRT could improve outcomes in head and neck cancer patients.

"Previous studies indicated that patients treated with IMRT did better when it came to treatment-related side effects, however these studies were not designed to examine survival," said Beth Beadle, M.D., Ph.D., assistant professor in MD Anderson's Radiation Oncology. "The survival data was not well-known because IMRT is intended to spare normal tissues but still deliver radiation to the tumor so previous models assumed it was equivalent survival at best."

IMRT employs multiple beams of radiation that allows oncologists to provide a dosage that conforms to the tumor, often at varying intensities, while limiting exposure to surrounding tissue.

Since being approved in 1999 for the treatment of head and neck cancer, IMRT use has substantially increased due to its advantages in being able to target complicated tumors while minimizing patient side effects such as xerostomia (chronic dry mouth), dental complications, fibrosis and range of motion impairments.

Researchers on the population-based retrospective study used the Surveillance, Epidemiology and End Results (SEER) Medicare database, compiled by the National Cancer Institute, to identify 3,172 patients treated for head and neck cancer between 1999—2007 who received either conventional radiation therapy or IMRT.

In total, 1,056 patients were treated with IMRT and 2,116 were treated with conventional therapy. All head and neck cancer subtypes were included, with the most common, squamous cell carcinoma, accounting for 91.2 percent. The primary outcome was cause-specific survival (CSS), which reflects the chances of dying from head and neck cancer after 40 months of follow-up.

To account for differences in the patient population with those being treated with IMRT possibly representing a different cohort due to the evolution of treatments, researchers used propensity scoring to create a matched comparison. This scoring model takes into account age at diagnosis, gender, race/ethnicity, income and education, among other factors.

Results Show Outcomes Improved

Beadle and colleagues found that patients treated with IMRT had a statistically significant improvement in CSS compared to those treated with conventional therapy, 38.9 percent vs. 18.9 percent, respectively.

Although propensity scoring matched patients for known variables, the researchers noted there was still a possibility for bias in the two treatment groups as a result of unmeasured variables. To account for this, an instrumental variable model was used that also demonstrated IMRT increased survival.

"From a scientific perspective, the findings support the use of IMRT and suggests we can provide excellent care while optimizing cancer outcomes and reducing toxicities," Beadle said. "At a more global level, with concerns about health care financing and resource allocation, IMRT is more expensive than conventional radiation therapy, but the data suggest it's worth it."

The authors note a separate and recent study (Yong et al.) that examined the cost effectiveness of IMRT in the treatment of oropharynx cancer found reason to support its use. Despite increased upfront costs, the study found IMRT could avoid a case of xerostomia with an incremental cost of $4,532.

Beadle said additional work is required to more closely examine the cost-effectiveness of IMRT. However, she noted that if the therapy can reduce or eliminate subsequent disease recurrences, or treatment-related side effects, the cost impact could be favorable.

With observational studies, the authors said limitations do exist including the uncertainty of Medicare claims data and the absence of data for younger patients. Additionally, the authors note there was an absence of human papillomavirus (HPV) status, which may affect tumor control.

None of the authors have conflicts to declare.

In addition to Beadle, other authors on the all-MD Anderson study include: Thomas Buchholz, M.D., division head Department of Radiation Oncology, B. Ashleigh Guadagnolo, M.D., associate professor, Department of Radiation Oncology, Adam Garden, M.D., professor, Department of Radiation Oncology, K. Kian Ang, M.D., Ph.D., professor, Department of Radiation Oncology, Linda Elting, Dr.P.H., professor and Kai-Ping Liao, Ph.D., both of the Department of Health Services Research.

Will Fitzgerald | EurekAlert!
Further information:
http://www.mdanderson.org

Further reports about: Cancer IMRT Radiation conventional therapy head and neck cancer neck cancer

More articles from Studies and Analyses:

nachricht WAKE-UP provides new treatment option for stroke patients | International study led by UKE
17.05.2018 | Universitätsklinikum Hamburg-Eppendorf

nachricht First form of therapy for childhood dementia CLN2 developed
25.04.2018 | Universitätsklinikum Hamburg-Eppendorf

All articles from Studies and Analyses >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Powerful IT security for the car of the future – research alliance develops new approaches

The more electronics steer, accelerate and brake cars, the more important it is to protect them against cyber-attacks. That is why 15 partners from industry and academia will work together over the next three years on new approaches to IT security in self-driving cars. The joint project goes by the name Security For Connected, Autonomous Cars (SecForCARs) and has funding of €7.2 million from the German Federal Ministry of Education and Research. Infineon is leading the project.

Vehicles already offer diverse communication interfaces and more and more automated functions, such as distance and lane-keeping assist systems. At the same...

Im Focus: Molecular switch will facilitate the development of pioneering electro-optical devices

A research team led by physicists at the Technical University of Munich (TUM) has developed molecular nanoswitches that can be toggled between two structurally different states using an applied voltage. They can serve as the basis for a pioneering class of devices that could replace silicon-based components with organic molecules.

The development of new electronic technologies drives the incessant reduction of functional component sizes. In the context of an international collaborative...

Im Focus: LZH showcases laser material processing of tomorrow at the LASYS 2018

At the LASYS 2018, from June 5th to 7th, the Laser Zentrum Hannover e.V. (LZH) will be showcasing processes for the laser material processing of tomorrow in hall 4 at stand 4E75. With blown bomb shells the LZH will present first results of a research project on civil security.

At this year's LASYS, the LZH will exhibit light-based processes such as cutting, welding, ablation and structuring as well as additive manufacturing for...

Im Focus: Self-illuminating pixels for a new display generation

There are videos on the internet that can make one marvel at technology. For example, a smartphone is casually bent around the arm or a thin-film display is rolled in all directions and with almost every diameter. From the user's point of view, this looks fantastic. From a professional point of view, however, the question arises: Is that already possible?

At Display Week 2018, scientists from the Fraunhofer Institute for Applied Polymer Research IAP will be demonstrating today’s technological possibilities and...

Im Focus: Explanation for puzzling quantum oscillations has been found

So-called quantum many-body scars allow quantum systems to stay out of equilibrium much longer, explaining experiment | Study published in Nature Physics

Recently, researchers from Harvard and MIT succeeded in trapping a record 53 atoms and individually controlling their quantum state, realizing what is called a...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

VideoLinks
Industry & Economy
Event News

In focus: Climate adapted plants

25.05.2018 | Event News

Save the date: Forum European Neuroscience – 07-11 July 2018 in Berlin, Germany

02.05.2018 | Event News

Invitation to the upcoming "Current Topics in Bioinformatics: Big Data in Genomics and Medicine"

13.04.2018 | Event News

 
Latest News

In focus: Climate adapted plants

25.05.2018 | Event News

Flow probes from the 3D printer

25.05.2018 | Machine Engineering

Less is more? Gene switch for healthy aging found

25.05.2018 | Life Sciences

VideoLinks
Science & Research
Overview of more VideoLinks >>>