Less radiation to treat head and neck cancer
PITTSBURGH, Pa. (Ivanhoe Newswire)- Head and neck cancers are continuing to increase in the United States, going up about five percent a year due to the prevalence of the human papilloma virus, or HPV. Patients are traditionally treated with surgery, followed by radiation. But now, researchers are testing a lower dose of radiation in some patients and the results may be practice changing.
Transoral robotic surgery, known as TORS, has become a surgeon’s preferred treatment for head and neck cancer, followed by radiation to destroy microscopic cancer cells left behind.
“It turns out that the side effects of radiation are very different than surgery,” Robert Ferris MD, PhD, and director of the UPMC Hillman Cancer Center explains.
Dr. Ferris and his colleagues conducted a phase two clinical trial, lowering the radiation dose in patients with an intermediate risk of cancer coming back. These patients have cancer that has spread between two and four lymph nodes. The researchers also determine how far outside the lymph node cancer has spread and assign a dose of radiation, either the standard dose of 60 or a lower dose of 50. Reducing the radiation dose from 60 to 50 might not sound like a lot, but it shortens treatment by a full week.
“And it turns out if you ask any cancer patient the first few weeks of radiation are reasonably tolerable, but then it gets progressively harder. And that final week is actually a lot in terms of the short-term acute side effects or toxicity,” Dr. Ferris says.
Researchers found the patients in both groups had survival rates of 95 percent two to three years after surgery and treatment.
“Because it was a pretty good-sized phase two trial, we may actually see that this changes practice in some centers across the U.S.,” Dr. Ferris tells Ivanhoe News.
Dr. Ferris says in the meantime, researchers at UPMC Hillman are looking at additional trials for patients who are considered high risk for recurrence to determine if substituting immunotherapies for standard chemotherapy will reduce side effects for those patients.
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