American Society for Radiation Oncology, Oct. 18-21

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The 57th Annual Meeting of the American Society for Radiation Oncology

The annual meeting of the American Society for Radiation Oncology (ASTRO) was held from Oct. 18 to 21 in San Antonio and attracted approximately 11,000 participants from around the world, including physicians, oncology nurses, radiation therapists, biologists, physicists, and other cancer researchers. The conference featured educational courses focusing on radiation, surgical, and medical oncology.

In one study, Paul W. Read, M.D., Ph.D., of the University of Virginia Health System in Charlottesville, and colleagues developed a solution for monitoring patients with advanced metastatic cancer in an effort to respond to their needs rapidly to reduce hospitalization rates.

The investigators integrated a simple patient-reported outcomes questionnaire based on the National Institutes of Health Patient Reported Outcomes Measurement Information System into their electronic medical record to monitor and display patient status that is shared by their health care team.

"This system, that we called MyCourse, longitudinally displays our patients' symptoms and functional scores and has built-in triggers to e-mail an alert to a palliative care nurse of rapidly worsening status," Read said. "We care for our patients as a multi-disciplinary team, with our palliative care physicians being integrated early and assuming more primary responsibility at the end of life."

According to Read, this team-based approach allows clinical practitioners to rapidly intervene with patient-specific, multi-disciplinary coordinated care plans and allows the palliative care physicians an opportunity to make substantial contributions to patient quality of life and establish a close relationship with patients.

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In another study, Susan Hiniker, M.D., of the Stanford Cancer Institute in California, and colleagues assessed whether ipilimumab and radiation could be delivered together safely without an increase in side effects for the treatment of metastatic melanoma. Secondary objectives included response rate as measured on imaging studies two to four weeks after the fourth cycle of ipilimumab, and every three months thereafter. The investigators also performed exploratory biomarker analysis in the serum of a subset of patients to identify biomarkers of response that could differentiate responders to therapy from non-responders.

"We found that the combination of ipilimumab plus radiation is safe, with no additional or synergistic toxicity above what is expected with each modality alone. Still, three out of 22 patients were unable to complete all four cycles of ipilimumab due to colitis, an immune-related side effect commonly seen with ipilimumab," Hiniker said. "We found an overall response rate of 28 percent, including complete and partial responses outside of the radiation field, with an additional 22 percent of patients having stable disease as best response. Furthermore, 14 percent of patients had a complete systemic response to therapy which is still ongoing at a median follow-up of 55 weeks."

Exploratory biomarker analysis suggests that responders to therapy may have higher serum levels of interleukin-2 and CD8+ T central memory cells, though further confirmation is required.

"Given the increased efficacy and reduced toxicity of programmed death-1 (PD-1) inhibitors as compared to ipilimumab, we are hopeful that combination PD-1 inhibition and radiation therapy may be even more effective and better tolerated than we found using ipilimumab alone," Hiniker added.

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Stephen Chun, M.D., of the University of Texas MD Anderson Cancer Center in Houston, and colleagues looked at a subset of lung cancer -- locally-advanced or stage III non-small-cell lung cancer to compare three-dimensional (3D) conformal radiation with intensity modulated radiation therapy (IMRT).

"In the trial we reviewed, RTOG 0617, which was one of the largest trials ever done for locally-advanced lung cancer, 47 percent were treated with IMRT and 53 percent with the 3D conformal technique. We observed that IMRT was associated with a statistically significant two-fold decrease in severe pneumonitis," Chun said.

The investigators also found that patients undergoing IMRT were 8 percent more likely to complete chemotherapy as well, which is a crucial part of treatment.

"Currently, the results of this study may dramatically increase use of IMRT for this population. While IMRT is more precise, has fewer side effects, and allows more patients to complete chemotherapy, it is more costly time-wise for patients and physicians. However, a hospitalization from pneumonitis can run upwards of tens of thousands of dollars. Preventing this potential toxicity will improve patient quality of life and reduce the cost of treating lung cancer," Chun said. "IMRT has been accepted to treat prostate, brain, and head and neck cancer for almost a decade because it has been shown to decrease toxicity in those sites. We hope these results encourage a similar change in the way we use IMRT for lung cancer as well."

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ASTRO: Less Treatment Effective in HPV-Related Oropharynx CA

FRIDAY, Oct. 23, 2015 (HealthDay News) -- Lower-level radiation and chemotherapy may be as effective as standard doses for some patients with human papillomavirus (HPV)-related oropharyngeal squamous cell carcinoma (OPSCC), and may cause fewer side effects, according to findings presented at the annual meeting of the American Society for Radiation Oncology (ASTRO), held from Oct. 18 to 21 in San Antonio.

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ASTRO: Shorter Radiation OK for Early Breast Cancers

WEDNESDAY, Oct. 21, 2015 (HealthDay News) -- Hypofractionated radiation therapy with incorporated boost over a shorter period of time treats early-stage breast cancer as well as longer, conventional radiation therapy, a new study suggests. The findings were scheduled to be presented at the annual meeting of the American Society for Radiation Oncology, held from Oct. 18 to 21 in San Antonio.

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ASTRO: Men's Health Supplements No Use in Prostate CA

MONDAY, Oct. 19, 2015 (HealthDay News) -- Men's health supplements (MHSs) offer no benefit for patients with localized prostate cancer, according to a study presented at the annual meeting of the American Society for Radiation Oncology, held from Oct. 18 to 21 in San Antonio.

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