American Society for Radiation Oncology, Oct. 31-Nov. 4, 2010Last Updated: November 10, 2010.
The 52nd annual meeting of the American Society for Radiation Oncology took place Oct. 31 to Nov. 4 in San Diego and attracted approximately 13,000 participants from around the world.
"Presentations at the conference looked at different types of treatments for prostate cancer, including external beam radiation, brachytherapy, and stereotactic radiation approaches. Some studies evaluated the effectiveness of external beam radiation as adjuvant or salvage therapy after a radical prostatectomy. In addition, investigators looked at different hormonal therapy approaches and how they should be incorporated into treatment. The theme for this year's meeting was Gathering Evidence and Proving Value," said Chandana Reddy, of the Cleveland Clinic.
Additional studies focused on radiation approaches for Hodgkin's lymphoma, bladder cancer, and breast cancer. In a late-breaking study, Sarah C. Darby, Ph.D., of Oxford University in the United Kingdom, and colleagues found that breast-conserving surgery followed by radiation therapy lowers the risk of breast cancer recurrence within 10 years by 14.6 percent and decreases the 15-year risk of death from breast cancer by 3.8 percent. The investigators reviewed records of 10,906 women in 17 randomized trials, assessing the efficacy of radiation therapy after breast-conserving surgery.
Among women with pathologically node-negative disease, the addition of radiation therapy reduced the 10-year risk of recurrence by 14.5 percent and the 15-year risk of death by 3.2 percent. The researchers also found that, among women with pathologically node-negative disease, benefit was dependent on age, tumor grade, and tamoxifen use. Among the 1,108 women with pathologically node-positive disease, radiation therapy reduced the 10-year risk of any recurrence by 17.7 percent and the 15-year risk of death by 7.8 percent.
"We are now able to determine which women will have a substantial benefit in terms of reducing the risk of recurrence and which women will have only a modest benefit. For those who receive a substantial benefit, radiation is really life saving and reduces the risk of dying of the disease considerably. For other women, radiation can still increase the chance that the breast can be saved, and it may also reduce the risk of dying from breast cancer by a small amount," Darby said. "I think that all women undergoing lumpectomy would benefit from considering adjuvant radiotherapy."
Among patients with early, intermediate-stage Hodgkin's lymphoma, Hans Theodor Eich, M.D., of the University of Cologne in Germany, and colleagues found that lower-dose radiation in combination with standard chemotherapy (ABVD) is not as effective as standard radiation and chemotherapy.
"We randomized 1,395 patients to ABVD and 30-Gy involved field radiation therapy, AVBD and 20-Gy involved field radiation therapy, BEACOPP with 30-Gy involved field radiation therapy, or BEACOPP with 20-Gy involved field radiation therapy," Eich said.
The investigators also found that BEACOPP was not more effective than ABVD and was associated with increased toxicity.
"Overall, the combination of ABVD and 30-Gy involved field radiation therapy is most effective for early, intermediate-stage Hodgkin's lymphoma," Eich said. "Thus, ABVD plus 30-Gy involved field radiation therapy remains the standard in combined modality outside clinical trials."
In another study, Nicholas James, M.D., of the University of Birmingham in the United Kingdom, and colleagues found that the addition of chemotherapy to radiation therapy prevents disease recurrence among patients with muscle-invasive bladder cancer. Among 458 invasive bladder cancer patients, the investigators evaluated whether adding chemotherapy to radiation treatment was effective and safe. In addition, the investigators compared two different radiation therapy approaches. The results of the study demonstrated that chemotherapy in combination with radiation reduced the long-term risk of bladder cancer recurrence and maintained bladder function.
"We demonstrated an excellent toxicity profile and better control rates than expected. We were able to reduce bladder failure rates at two years, with a 33 percent decrease in the rate of bladder failure. We also saw a 50 percent decrease in invasive recurrence in combination with lower bladder failure rates," James said.
The addition of chemotherapy to radiation in patients with invasive bladder cancer did not increase toxicity greatly compared to radiation therapy alone.
"We are continuing to follow whether there is an increase in the survival rate. We believe the combination of excellent bladder preservation rates and low toxicity has the potential to transform the treatment options for older patients with bladder cancer, particularly those who may currently be offered only palliative treatments," James said.
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ASTRO: Aspirin May Lower Risk of Prostate Cancer Death
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