Even as a cornerstone of cancer treatment, the complexities and challenges of radiotherapy continue to inspire breakthroughs in patient care. Explore 3 peer-reviewed studies that showcase innovative advancements in radiotherapy, from emboldening treatment access to improving clinical outcomes.
Research coming out of Sao Paulo, Brazil, supports the use of ultrahypofractionated radiation therapy for older patients with breast cancer, offering a shorter and potentially more convenient treatment schedule without compromising outcomes.1
The nonrandomized trial evaluated the safety and efficacy of ultrahypofractionated radiotherapy in 60 patients with breast cancer aged >65 years. Participants, most of whom had stage I or II disease, were given approximately 5 fractions of 5.7 Gy on alternate days over 1 to 2 weeks. The primary end point of the study was acute toxicity.
Across 42 months of follow-up, most patients had only mild side effects (grade 1 or 2) with no severe acute toxicity and only rare late side effects (eg, fibrosis and pneumonitis). Survival rates were promising, with a 3-year disease-free survival of 81.7% and overall survival of 86.7%.
Treatment did not negatively impact the appearance of the treated area, quality of life, or survival outcomes, even when regional lymph nodes were irradiated. These findings spotlight ultrahypofractionated radiation therapy as a safer, more efficient treatment option for older patients that won’t sacrifice cosmetic results, well-being, or effectiveness.
Patient navigators are essential in empowering patients with the education they need about radiation therapy, especially when seeking out shorter treatment options that increase convenience, reduce travel burden, and enhance comfort.
Immune checkpoint inhibitors (ICIs) administered with brain radiotherapy for non–small cell lung cancer (NSCLC) and brain metastases yielded higher rates of intracranial response than ICIs administered alone, a multicenter retrospective study has shown.2
A total of 138 patients were included in the study, which examined—among other outcomes—overall response rate (ORR), intracranial ORR (iORR), and treatment-related toxicities.
Among the 82 patients with available data, combination therapy showed a higher iORR (76% vs 49% with ICIs alone) without increasing the incidence of serious adverse events. Furthermore, improved survival trends were observed in patients requiring steroids who received the combination treatment.
These study findings highlight the potential benefits of combining ICIs with brain radiotherapy for patients with brain metastases, particularly in subgroups needing corticosteroid support.
“In the era of immunotherapy, this study presents compelling real-world evidence elucidating the potential benefits of integrating ICIs with brain radiotherapy in the management of NSCLC patients with BMs [brain metastases],” concluded the researchers.2
The IChoice-02 trial offers new hope for patients with human papillomavirus (HPV)-associated oropharyngeal cancer (OPC) by exploring a less intensive treatment approach with the addition of immunotherapy.
This study evaluated whether induction chemoimmunotherapy, followed by response-adapted de-escalation of radiotherapy and omission of concurrent chemotherapy, could maintain strong survival outcomes while reducing treatment intensity and associated toxicities.
A total of 97 patients with HPV-positive OPC (stages I-III) were administered 2 cycles of induction chemoimmunotherapy with toripalimab and platinum-based chemotherapy.
Fifty-nine patients with deep radiological responses (≥50% reduction in tumor size) received reduced-dose radiotherapy (60 Gy) without concurrent chemotherapy, while 38 patients without a deep response received standard-dose radiotherapy (70 Gy) with concurrent chemotherapy.
One-year progression-free survival rates were impressive across the board, with 96.1% in the de-escalation group, 87.8% in the standard treatment group, and 92.9% for the full cohort; overall survival at 1 year was 100% across all groups.
Relapse rates were low, with only 2 patients in the de-escalation arm experiencing in-field relapses, compared with 6 in the standard treatment arm who experienced locoregional, distant, or combined treatment failures.
The de-escalation approach did not increase treatment-related risks, as no treatment-related deaths were reported, suggesting that a less intensive therapy may be a safe and effective option for certain patients.
Importantly, the de-escalation approach did not increase treatment-related risks, as no treatment-related deaths were reported, suggesting that a less intensive therapy may be a safe and effective option for certain patients. Unexpected findings included 2 cases of second primary malignancies (ie, intracranial lymphoma and melanoma) within 4 months of treatment completion.
While these early results are promising, longer follow-up is needed to confirm the durability of these outcomes and further refine treatment strategies for this patient population.
Portions of this article were written with AI assist.
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