Radiation Therapy

Radiation Therapy

Technology advancements in radiation therapy have allowed treatment to be tailored to a patient's tumor type, size, and location to minimize the risk of damage to healthy tissue, improve survival, and minimize potentially serious side effects.

While radiologists once drew up treatment plans with a wax pencil on X-ray films, they now construct intricate, computerized treatment plans based on 3-D images of the tumor and can vary both the shape and intensity of radiation beams. One of the earliest radiation techniques, brachytherapy, now offers effective treatment for prostate, cervical and other tumors by directly implanting small radioactive sources temporarily or permanently into tumors via remote-operated equipment.
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2017

Increasing time between radiation and rectal cancer surgery lowers risks of surgical complications

Increasing time between radiation and rectal cancer surgery lowers risks of surgical complications

A large trial shows that delaying surgery for as long as 8 weeks after completing radiation (either short- or standard-course treatment) does not increase the risk of rectal cancer recurring, compared to having surgery within 1 week after completion of the short-course radiation treatment. Patients who received short-course radiation therapy and delayed surgery have a much lower risk of complications after surgery than those who received the same radiation without a delay in surgery. This data establishes shorter-course radiation with delayed surgery as an important new option for patients, with important benefits for their recovery at multiple points of treatment.

More Information: 

N Engl J Med 2017;376:2211-2222
Reduced radiation dose for HPV-associated throat cancer reduces long-term complications

Reduced radiation dose for HPV-associated throat cancer reduces long-term complications

Two clinical trials show that lowering the standard radiation dose by 15% to 20% does not compromise survival for individuals with HPV-associated oropharyngeal cancer. Furthermore, one of the studies shows that those who receive the lower dose are far less likely to have difficulty swallowing solids or impaired nutrition a year after treatment. HPV-associated oropharyngeal cancers are increasing, and while they typically respond well to treatment, those diagnosed tend to be younger and can be affected by these treatment-related complications for decades – making reductions in long-term effects especially important.

More Information: 

J Clin Oncol 2017;35:490-497
Lancet Oncol 2017;18:803-811

2016

A new standard of care for high-risk, low-grade gliomas

A new standard of care for high-risk, low-grade gliomas

Badge indicating that research was paid for using federal funds

A federally-funded clinical trial shows that adding a chemotherapy regimen called PCV (procarbazine, CCNU, and vincristine) to radiation therapy slows cancer growth of grade 2 glioma and extends survival by a median of 5 years. Grade 2 gliomas are a rare, slow-growing type of brain tumor that occur most often in young people. As a result of this study, PCV chemotherapy after radiation therapy is now the standard of care for high-risk, low-grade gliomas.

More Information: 

JCO 2014; 32(Suppl. 15): 2000
N Engl J Med 2016; 374:1344-1355

2012

Adding radiation to chemotherapy after surgery still benefits some patients

Adding radiation to chemotherapy after surgery still benefits some patients

Building on the results of a 2011 Korean trial, a study suggests that for patients with stomach cancer that has spread to the lymph nodes, there is a small but significant improvement in survival from adding radiation to adjuvant (post-surgical) chemotherapy, in this case using the drugs capecitabine (Xeloda) and cisplatin. A larger trial is currently underway to confirm these results.

Because radiation only slightly improved outcomes, adjuvant chemotherapy alone after aggressive surgery also remains a viable treatment option for certain patients.

More Information: 

Journal of Clinical Oncology 2012; 30(3): 268-73

2009

Radiation after surgery or hormone therapy improves survival

Radiation after surgery or hormone therapy improves survival

Badge indicating that research was paid for using federal funds

Findings from a long-running clinical trial show that radiation therapy after surgery (known as adjuvant radiation) reduces the risk that prostate cancer will spread and increases survival time by nearly 30 percent in men with early-stage disease. A separate study finds that adding external beam radiation treatment to standard hormone therapy in prostate cancer that has spread to the surrounding areas can reduce the risk of death by more than 40 percent.

More Information: 

Cancer.Net; Prostate Cancer: Treatment Options
Journal of Urology; 181(3): 956–962

2007

Shorter course of radiation therapy is as effective as less frequent radiation therapy for early-stage breast cancer

Shorter course of radiation therapy is as effective as less frequent radiation therapy for early-stage breast cancer

Findings from the START Trial suggest that "hypofractionated" radiation therapy, which involves fewer but larger doses of radiation delivered over a shorter period of time, is as effective as conventional radiation for reducing the risk of cancer recurrence among women with early-stage breast cancer, and does not cause greater damage to healthy breast tissue. Since traditional radiation therapy for breast cancer can take five to six weeks to complete, this shorter course (as little as three weeks) is a more convenient option for some patients and makes it easier to complete all cycles of treatment.

2006

Genetic mutations affect survival for oligodendroglioma

Genetic mutations affect survival for oligodendroglioma

Badge indicating that research was paid for using federal funds

Two studies find that patients with oligodendroglioma tumors (a form of glioma) that lack certain parts of chromosomes 1 and 19 are more sensitive to treatment and have better survival than patients whose tumors are not missing this genetic material. Follow-up data later show that these patients fare much better, living several years longer, when they receive chemotherapy and radiation together, rather than radiation alone. 

More Information: 

JCO 2006; 24(18): 2707-2714
JCO 2006; 24(18): 2715-2722
JCO 2013; 31(3): 337-343
JCO 2013; 31(3): 344-350

2005

High-dose radiation helps men avoid cancer recurrence

High-dose radiation helps men avoid cancer recurrence

Badge indicating that research was paid for using federal funds

Studies find that men with localized prostate cancer who receive radiation treatment at a higher dose than was traditionally provided are less likely to have their cancer recur than men who receive conventional radiation. The high-dose approach is made possible by technological advances that allow doctors to precisely target more radiation to the tumor, while sparing healthy tissue.

More Information: 

Lancet 2005; 366(9485): 572-78

2004

Chemotherapy and radiation before surgery reduce side effects for rectal cancer patients

Chemotherapy and radiation before surgery reduce side effects for rectal cancer patients

Results from a large clinical study show that giving chemotherapy and radiation therapy before, rather than after, rectal cancer surgery reduces the risk of local recurrence (cancer recurrence in the pelvis, near the original tumor). Survival was similar in both approaches, but because the pre-surgery treatment regimen was more tolerable, it is now the standard approach for treatment of rectal cancer.

More Information: 

Cancer.Net; Colorectal Cancer: Treatment Options
N Engl J Med 2004; 351: 1731-1740

2001

Adjuvant therapy improves long-term survival for patients with early-stage stomach cancer

Adjuvant therapy improves long-term survival for patients with early-stage stomach cancer

Badge indicating that research was paid for using federal funds

In 2001, a major trial shows that giving patients chemotherapy and radiation after surgery – an approach known as adjuvant therapy – significantly improves survival. The study compared surgery alone with surgery followed by the chemotherapy drugs fluorouracil and leucovorin, together with radiation.

These findings quickly establish adjuvant chemotherapy and radiation as a standard of care, and make stomach cancer one of several cancers in which adjuvant therapy can increase patients' chances of cure.

More Information: 

N Engl J Med; 345(10)
Journal of Clinical Oncology 2012; 30(19): 2327-33

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