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Some patients with oropharyngeal cancer may be eligible to reduce radiation therapy and reduce side effects

Patients with p16-positive oropharyngeal cancer (meaning the disease may have been linked to the human papillomavirus, also known as HPV) may be able to find out if they can receive a lower radiation dose during the second half of their treatment transmitted by PET scans before and halfway through their treatment, according to recent results from a phase 2 trial.

Researchers used an agent called fluorodeoxyglucose (FDG) to help see cancer more clearly on PET scans, seeing how well the disease responded to chemotherapy. FDG is typically used to detect cancer in PET scans, but this is the first test to use it in the middle of treatment.

“Advanced imaging helps physicians customize therapy based on individual patient tumor characteristics and response to treatment. By incorporating FDG-PET scans before and midway through treatment, we were able to adjust the dose of radiation for about half of our patients and reduce their short- to long-term side effects while focusing on tumor control,” said study lead author Dr. Steven Allen, radiation oncology resident. at the University of Michigan, in a statement.

Patients who had tumors with low metabolic activity before treatment, then 50% or more shrinkage after two weeks of chemoradiotherapy, had their treatment reduced to receive a lower dose (approximately 25% less) of radiation.

Although this tended to keep the cancer at bay, it spared patients some of the side effects of treatment. Half of the patients in the trial ended up receiving a dose reduction, and they tended to lose significantly less weight, were less likely to need a feeding tube, and tended to have better swallowing function, according to a swallowing video study that was conducted. during treatment.

“We had anticipated long-term improvements in side effects, but the short-term improvements were better than expected,” said lead author and principal investigator Dr. Michelle L Mierzwa, associate chair of clinical research and co-chair of the clinical trials on the head and neck. at the University of Michigan. “Experiencing fewer short-term side effects potentially allows patients to return to normal activities more quickly.”

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