BARCELONA—Accelerated partial breast irradiation (ABPI) brachytherapy completed in a single week gave at least as good efficacy and safety as other radiotherapy protocols after breast-conserving therapy (BCS) for patients with low-risk breast cancer and brought advantages in terms of symptoms and convenience in a randomized phase three trial(conducted at 16 European medical centers)reported at the 2018 European Society for Radiotherapy & Oncology (ESTRO 37) conference. (OC-0326 QOL After APBI (Multicatheter Brachytherapy) Versus WBI: 5-Year Results, Phase 3 GEC-ESTRO Trial)
“We really have to consider further reducing treatment burden for patients with low-risk breast cancer,” said radiation oncologist Philip Poortmans MD PhD, past ESTRO president, Marie Curie Professor and head of department at Paris Science & Lettres, Institut Curie in Paris commenting on the study findings. “And an excellent approach to this is accelerated partial breast irradiation—for which brachytherapy is an excellent solution,”
First author Rebekka Schäfer MD, Resident Medical Doctor at Würzburg University Hospital in Würzburg, Germany talks with the Audio Journal of Oncology about her study in which APBI with brachytherapy was compared directly to whole breast irradiation in the study and was not inferior in terms of overall survival and local recurrence at five years.
Yolande Lievens MD PhD, head of the department of radiation oncology at Ghent University Hospital in Belgium, said the findings endorsed brachytherapy as an option which improved opportunities for individualizing therapy and limiting the volume of the breast being irradiated.
BARCELONA—Image-guided adaptive brachytherapy (IGABT) for patients with cervical cancer did not increase risk for ureteral stricture (a rare but feared complication of pelvic radiotherapy) in European research reported at the European Society for Radiotherapy & Oncology (ESTRO 37) 2018 conference.
(OC-0072 Risk factors for ureteral stricture after IGABT in cervical cancer: results from the EMBRACE studies)
“Our findings show that the risks for severe to life-threatening ureteral strictures are very low in all the patients with limited stage disease,” said first author Lars Fokdal MD PhD, a clinical oncologist from Aarhus University Hospital in Denmark, who told the Audio Journal of Oncology about his group’s updated population-based findings and conclusions from analysis of data from 1772 patients treated with brachytherapy for their locally advanced cervical cancer (LACC) in the retrospective RetroEMBRACE study (with 610 patients) and the prospective EMBRACE (with 1162 patients).
BARCELONA—It is essential to conduct a comprehensive geriatric assessment of patients over 74 with lung cancer before deciding to escalate treatment dose by switching to concurrent chemo-radiotherapy in an attempt to improve outcomes. This was the conclusion of a phase 2 study reported at the European Society for Radiotherapy & Oncology (ESTRO 37) conference.
(PV-0039 Outcome of elderly NSCLC patients treated with isotoxic RT dose-escalation using IMRT—NCT01166204)
Principal investigator Judith van Loon MD PhD, a radiation oncologist at MAASTRO Clinic in Maastricht, The Netherlands told the Audio Journal of Oncology that clinicians could do more harm than good with this treatment if they did not take into account other factors, and that this held true despite the fact that only patients who had excellent performance status were selected for such escalation.180519 van Loon AJO INTERVIEW Production MASTER
BARCELONA—The accuracy of radiation targeting using image-guided radiotherapy (IGRT) was significantly associated with overall survival in a study of a large cohort of patients treated with IGRT for their lung and esophageal cancers. reported at the 2018 European Society For Radiotherapy and Oncology (ESTRO 37) annual conference (ABSTRACT OC-0322, “Residual setup errors after IGRT are linked to overall survival in lung and oesophageal cancers”)
The key hazard was found to be unintended irradiation of the heart. Patients who had residual set-up errors which moved their hearts closer to the high-dose region had significantly worse overall survival compared to those who had a residual shifts away from the heart said first author Corinne Johnson MSc, a physics PhD student at Christie NHS Foundation Trust, University of Manchester and Manchester Cancer Research Centre in the UK in conversation with the Audio Journal of Oncology.Corinne Johnson AJO Production MASTER
BARCELONA—Ultrahypofractionated radiation (U-HF) delivered in only seven fractions (each triple the usual dose) in two and a half weeks was just as effective for treating intermediate-risk prostate cancer—with no greater toxicity—as a standard protocol with 39 fractions over eight-weeks in findings from the phase 3 Scandinavian HYPO-RT-PC study reported at the 2018 European Society For Radiotherapy and Oncology (ESTRO 37) annual conference. http://www.mynewsdesk.com/se/umea_universitet/documents/abstract-prostatastudie-77805
Anders Widmark MD PhD, Professor of Oncology and Senior Consultant in the Department of Radiation Oncology and the Umeå University Hospital Cancer Centre in Umeå, North Sweden talks with the Audio Journal of Oncology about why they undertook their study and about the clinical implications of their findings.Anders Widmark AJO Production Master
BARCELONA—Women who develop breast symptoms—especially lumps—between regular mammography screening examinations are up to four times more likely to have a diagnosis of breast cancer soon after than women who do not have symptoms according to findings of a massive study of routine mammography from Finland reported at the 2018 European Breast Cancer Conference (EBCC 11).
“Women with symptoms should be taken as a different, separate group—a high risk group. So they will have different screening strategies from women without symptoms [with] more further assessment like ultrasound, further mammography or biopsy and close monitoring,” said study author Deependra Singh MPH who works in the Research Laboratory of the Finnish Cancer Registry in Helsinki, Finland.
Breast symptoms and risk of interval breast cancers in mammography-screening programme
https://www.ecco-org.eu/Events/EBCC11/Searchable-Programme#anchorScprDeependra Singh AUDIO JOURNAL OF ONCOLOGY
BARCELONA—More pre-menopausal women who have estrogen receptor (ER) positive advanced breast cancer could be spared chemotherapy—according to latest findings from the MONALEESA-7 double-blind randomized phase 3 trial in which either placebo (PBO) or the cyclin-dependent kinase (CDK) 4/6 inhibitor ribociclib (RIB) were added to tamoxifen (TAM) or a non-steroidal aromatase inhibitor (NSAI) with all patients also having ovarian suppression by goserelin therapy.
At the 2018 European Breast Cancer Conference (EBCC 11) Nadia Harbeck MD, Professor of Gynaecology and head of the Breast Center at the University of Munich in Germany said that following her group’s latest study findings practice should change for young, pre-menopausal patients who presented for the first time with hormone receptor positive human epidermal growth factor receptor2- (HER2)-negative advanced breast cancer. She discusses her findings with the Audio Journal of Oncology.
Emiel J T Rutgers MD PhD FRCS from the Netherlands Cancer Institute, Professor of Surgical Oncolology at the University of Amsterdam, who was not involved with the study, said the results were very interesting. “We have now another possibility added to our armamentarium. My opinion is that in pre-menopausal women who recur with hormone-sensitive estrogen-dependent breast cancer with visceral or bony metastasis a re-challenge with anti-hormonal treatment including ribociclib or a comparable [agent] is now the first option. And the side-effect profile is rather mild—so that’s another positive thing about it.”
LATE BREAKING ABSTRACT 1LBA:
Ribociclib (RIB) plus tamoxifen (TAM) or a non-steroidal aromatase inhibitor (NSAI) in premenopausal women with hormone receptor-positive (HR+), human epidermal growth factor receptor 2-negative (HER2–) advanced breast cancer (ABC): additional results from the MONALEESA-7 trial
Nadia Harbeck with Emiel Rutgers AJO PRODUCTION MASTER
BARCELONA—A multicenter nationwide Italian study of patients with ductal carcinoma in situ (DCIS) treated with breast conservative surgery (BCS) and whole breast radiotherapy (RT) has updated risk criteria to help women opt for gentler treatments and avoid toxicities from overtreatment.
At the 2018 European Breast Cancer Conference Icro Meattini MD, Consultant Clinical Oncologist in the Radiation Oncology Department at Azienda Ospedaliero-Universitaria Careggi, University of Florence, Italy said: “A diagnosis of DCIS can be frightening but also confusing. Although we know that very few patients will go on to develop invasive cancer we don’t know which ones they will be and so we offer treatments such as surgery and radiotherapy and sometimes hormone therapy.” He discusses the findings of his study with the Audio Journal of Oncology.Icro Meattini AJO PRODUCTION MASTER
BARCELONA—Not only was breast conserving therapy safer than mastectomy for most low-risk patients in the large randomized EORTC 10041/BIG 03-04 MINDACT trial reported at the 2018 European Breast Cancer Conference but also many patients could be advised to avoid chemotherapy and radiotherapy altogether after assessing their risk as “low” by using a combination of clinical and genetic risk scores, the study concluded.
Emiel Rutgers MD, PhD, a surgeon at the Netherlands Cancer Institute and professor of surgical oncology at the University of Amsterdam said MINDACT found an overall five-year loco-regional recurrence rate of only 2.1 per cent in patients treated conservatively and 2.5 per cent in those who had mastectomy. Tumor size and grade were the only independent risk factors and the results provided “the opportunity to prospectively study de-escalation of radiotherapy in women with low-risk early breast cancer”. He discussed his study and the clinical implications for the Audio Journal of Oncology.Emiel Rutgers AJO PRODUCTION MASTER
OMAHA, NEBRASKA—Children with hemiplegic cerebral palsy achieved improved functioning of the prefrontal cortex regions of their brains in a study using intense exercise sessions—designed as games—in which both hands had to be used together to achieve specific manual dexterity tasks.
In the investigation—published in Pediatric Physical Therapy journal (Pediatr Phys Ther 2018;0:1–8)—lead author Swati Surkar PT, PhD from the Sensorimotor Learning Laboratory, at the Munroe-Meyer Institute in the University of Nebraska Medical Center, Omaha, described her group’s findings from the trial in a cohort of children with hemiplegic cerebral palsy who had only one arm functioning normally and needed to get their impaired limbs to perform motor tasks more effectively.
The researchers tracked brain functioning before and after therapy by using functional near-infrared spectroscopy (fNIRS) to detect cerebral cortical oxygenation.
They concluded that not only did the bimanual therapy (known as Hand Arm Bimanual Intensive Therapy—HABIT) help children achieve significant improvements in affected limb function but children also had a clear increase of the brain’s ability to plan strategies to achieve the skill tasks required by the HABIT protocol.
Senior study author Max Kurz PhD, Associate Professor in the Department of Physical Therapy at the Munroe-Meyer Institute in the University of Nebraska Medical Center, Omaha, commented that the findings had potential implications far beyond treatment for cerebral palsy and give confirmation that intensive physical exercise brings direct benefit to the brain.
April 10, 2018 in Pediatric Physical Therapy journal:
Hand-Arm Bimanual Intensive Therapy Improves Prefrontal Cortex Activation in Children With Hemiplegic Cerebral Palsy
Swati M. Surkar, PT, PhD; Rashelle M. Hoffman, PT, DPT; Sandra Willett, PT, PCS, MS; Janice Flegle, OTRL; Regina Harbourne, PT, PCS, PhD; Max J. Kurz, PhD URL: journals.lww.com/pedpt/pages/default.aspx
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