乌鸦传媒

Patients with resectable pancreatic cancer lived longer if they received higher doses of radiation as part of adjuvant chemoradiation, according to retrospective analysis of data from Europe and the U.S.

Patients who received a total radiation dose of at least 55 Gy had a median survival of 28 months, double that of patients who received less than 45 Gy. Survival increased incrementally with increasing radiation dose, as reported at the meeting in Vienna.

"Previous research has not shown a benefit for treating pancreatic cancer with radiotherapy, suggesting that these tumors are somehow resistant to radiation, but this study suggests the situation is more nuanced," Francesco Cellini, MD, of Catholic University of the Sacred Heart in Rome, said in a statement. "We have found that the higher the dose, the longer the patient is likely to survive. This may indicate that the doses were simply not high enough in previous research."

The results came from an analysis of 514 patients with organ-confined, operable pancreatic cancer. After surgery, all patients received chemoradiation and were followed for a median duration of 20 months. The results showed a median survival of 13 months for patients who received a radiation dose <45 Gy, increasing to 21 months for ≥45 to <50 Gy, 22 months for ≥50 to <55 Gy, and 28 months for ≥55 Gy. By multivariate analysis, a higher dose of radiation had a significant association with improved survival (HR 0.46, 95% CI 0.27-0.78, P=0.005).

Kids and Videos During RT

Allowing children to watch videos during radiation therapy led to a 60% reduction in the use of anesthesia during treatment sessions, a small pilot study showed.

Prior to introduction of the video, six treated children required anesthesia in 83% of sessions to remain still during administration of radiation therapy. During the evaluation of the video intervention in six additional children, the anesthesia requirement declined to one-third of treatment sessions. The duration of each treatment session decreased from an hour or more to 15 or 20 minutes.

"Now in our clinic, video has almost completely replaced anesthesia, resulting in reduced treatment times and reduction of stress for the young patients and their families," said Catia Aguas, a radiation therapist at Saint Luke University Clinics in Brussels, Belgium.

The video intervention had its genesis in the recognition that radiation therapy can be emotionally traumatic to pediatric patients, their families, and radiotherapy personnel. Treatment of conditions such as brain tumors and soft-tissue sarcomas require patients to remain motionless for prolonged periods during administration of radiotherapy. Additionally, use of anesthesia requires patients to fast for at least 6 hours prior to administration.

The clinical evaluation involved children ages 1.5 to 6 years. Aguas said the intervention was inexpensive, requiring only a video projector and readily available animated children's programming.

RT and Penile Cancer

Use of brachytherapy instead of surgery as initial treatment for penile cancer led to a high rate of long-term organ preservation and survival, results of a single-center clinical experience showed.

Overall, 201 men had an 85% likelihood of survival with an intact penis at 5 years and overall survival of 79%, including 82% cancer-specific survival. Eight patients required surgical removal of the penis because of recurrent disease, and 18 others required varying degrees of surgical excision because of recurrence.

"These results show that brachytherapy is the treatment of choice for selected patients whose cancer had not spread into the sponge-like regions of the erectile tissue in the penis -- the corpus cavernosum," said Alexandre Escande, MD, of Gustave Roussy Cancer Institute in Villejuif, France. "It is effective at controlling and eradicating the cancer and allows a high number of men to preserve their penises."

The study involved men ≥45 with localized penile cancer. Treatment consisted of circumcision and brachytherapy at doses of 36.5 to 76 Gy. The cohort had a median follow-up of 10.7 years. Disease recurrence was associated with tumors >4 cm² and treatment with a radiation dose <62 Gy. Escande said 13 patients required surgical treatment associated with radiation toxicity.