PRESS-NEWS.org - Press Release Distribution
PRESS RELEASES DISTRIBUTION

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

IMRT reduces side effects, also improves outcomes

2014-01-13
(Press-News.org) Contact information: Will Fitzgerald
wbfitzgerald@mdanderson.org
713-792-9518
University of Texas M. D. Anderson Cancer Center
Study finds more targeted form of radiation improves survival in patients with head and neck cancers IMRT reduces side effects, also improves outcomes HOUSTON — 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.


ELSE PRESS RELEASES FROM THIS DATE:

White parents more likely to use age-appropriate car seats than non-whites

2014-01-13
White parents more likely to use age-appropriate car seats than non-whites Race of parents remains a key predictor of whether children will be placed in the right safety seat, according to new U-M study Ann Arbor, Mich. — White parents reported higher ...

Fear of being too skinny may put teen boys at risk for depression, steroid use

2014-01-13
Fear of being too skinny may put teen boys at risk for depression, steroid use Steroid use more likely among depressed and bullying victims, study finds WASHINGTON – Teenage boys who think they're too skinny when they are actually a healthy weight are ...

'Superlens' extends range of wireless power transfer

2014-01-11
'Superlens' extends range of wireless power transfer Engineers accomplish the first relatively long-range wireless power transfer by 'beaming' electromagnetic fields DURHAM, N.C. -- Inventor Nikola Tesla imagined the technology to transmit energy through thin air almost ...

Social media helps users embrace differences and provide support to one another, MU study finds

2014-01-11
Social media helps users embrace differences and provide support to one another, MU study finds Lady Gaga enables followers to embrace their awkwardness while deepening the perceived relationship they feel they have with the celebrity COLUMBIA, Mo. ...

Study: Autophagy predicts which cancer cells live and die when faced with anti-cancer drugs

2014-01-11
Study: Autophagy predicts which cancer cells live and die when faced with anti-cancer drugs When a tumor is treated with an anti-cancer drug, some cells die and, unfortunately, some cells tend to live. A University of Colorado Cancer Center study published in the ...

Text messaging boosts flu vaccine rates in pregnant women

2014-01-11
Text messaging boosts flu vaccine rates in pregnant women January 10, 2014 --A study by researchers at the Mailman School of Public Health evaluated the impact of text messaging reminders for influenza vaccine in a low-income obstetric ...

Complementary medicine in wide use to treat children with autism, developmental delay

2014-01-11
Complementary medicine in wide use to treat children with autism, developmental delay

Study shows large carnivore numbers and range declining worldwide

2014-01-10
Study shows large carnivore numbers and range declining worldwide MISSOULA – New research co-written by University of Montana scientists finds steep declines in the worldwide populations and habitat range of 31 large carnivore species. The analysis, ...

Harvard scientists control cells following transplantation, from the inside out

2014-01-10
Harvard scientists control cells following transplantation, from the inside out New work by Jeffrey Karp, Ph.D., has potential to make cell therapies more functional and efficient Harvard stem cells scientists at Brigham and Women's Hospital and MIT can now engineer ...

Indigenous groups more vulnerable in the fight against flu

2014-01-10
Indigenous groups more vulnerable in the fight against flu Research indicated that some Indigenous people such as in Alaska and Australia displayed limited immunity response to the effects of influenza. Published in the Journal Proceedings of the National ...

LAST 30 PRESS RELEASES:

Corpse flowers are threatened by spotty recordkeeping

Riding the AI wave toward rapid, precise ocean simulations

Are lifetimes of big appliances really shrinking?

Pink skies

Monkeys are world’s best yodellers - new research

Key differences between visual- and memory-led Alzheimer’s discovered

% weight loss targets in obesity management – is this the wrong objective?

An app can change how you see yourself at work

NYC speed cameras take six months to change driver behavior, effects vary by neighborhood, new study reveals

New research shows that propaganda is on the rise in China

Even the richest Americans face shorter lifespans than their European counterparts, study finds

Novel genes linked to rare childhood diarrhea

New computer model reveals how Bronze Age Scandinavians could have crossed the sea

Novel point-of-care technology delivers accurate HIV results in minutes

Researchers reveal key brain differences to explain why Ritalin helps improve focus in some more than others

Study finds nearly five-fold increase in hospitalizations for common cause of stroke

Study reveals how alcohol abuse damages cognition

Medicinal cannabis is linked to long-term benefits in health-related quality of life

Microplastics detected in cat placentas and fetuses during early pregnancy

Ancient amphibians as big as alligators died in mass mortality event in Triassic Wyoming

Scientists uncover the first clear evidence of air sacs in the fossilized bones of alvarezsaurian dinosaurs: the "hollow bones" which help modern day birds to fly

Alcohol makes male flies sexy

TB patients globally often incur "catastrophic costs" of up to $11,329 USD, despite many countries offering free treatment, with predominant drivers of cost being hospitalization and loss of income

Study links teen girls’ screen time to sleep disruptions and depression

Scientists unveil starfish-inspired wearable tech for heart monitoring

Footprints reveal prehistoric Scottish lagoons were stomping grounds for giant Jurassic dinosaurs

AI effectively predicts dementia risk in American Indian/Alaska Native elders

First guideline on newborn screening for cystic fibrosis calls for changes in practice to improve outcomes

Existing international law can help secure peace and security in outer space, study shows

Pinning down the process of West Nile virus transmission

[Press-News.org] Study finds more targeted form of radiation improves survival in patients with head and neck cancers
IMRT reduces side effects, also improves outcomes