In a recently published study, a new radiotherapy system that lowers the radiation delivered to healthy tissue was assessed. The new system offers an additional option for the treatment of oral cancer as well as cancer of the pharynx.
The study was carried out by a Spanish team from the University of Granada and the Virgen de las Nieves University Hospital in Granada. Data was collected between 2005 and 2008. The study involved 80 patients identified with epidermoid cancer of the oral cavity and pharynx. The patients had their lymph nodes removed. During the surgery, the nodes were divided into various risk levels. This classification helped doctors in focusing on the areas with higher risk for recurrence. Consequently, neck regions with a lower risk for inclusion of residual cancer cells did not receive radiation.
Nearly 70% of oral cancer and cancer of the pharynx, after undergoing surgery, require additional radiotherapy and sometimes chemotherapy. These additional procedures are required to counteract the possibility of recurrence. However, both radiotherapy and chemotherapy are highly toxic. Both also have complications, such as ulcer development in the oral cavity; with the latter sometimes resulting in patients refusing to continue with a treatment program.
Thanks to the new approach discussed in the study, radiation will be delivered to neck areas according to the risk of recurrence. This advance in management means that a smaller area in the neck will receive radiotherapy. And this should result in fewer side effects and more compliance from patients.
The team was led by Miguel Martínez Carrillo, a radiation oncologist at the university hospital. He and his colleagues worked in cooperation with the Services of Radiation Oncology, Medical Physics, Maxillofacial Surgery and Pathology at the university hospital and the Department of Radiology and Physical Medicine at the University of Granada.
The new technique was evaluated by the study team in 3 year of follow up. It was noted that the new approach resulted in reducing the neck area receiving radiotherapy in 44% of patients. Nearly 118 cm3 of neck tissue was spared the radiation effect.
Compliance also improved thanks to the new approach. Around 95% of patients finished the radiotherapy course with much less toxicity and side effects. Recurrence rates did not appear to be altered by the new approach although long term follow-up is not available.