DCIS is a Bona Fide Breast Cancer, Not a Cancer Precursor

MedicalResearch.com Interview with:

Steven Narod, MD, FRCPC, FRSC Senior Scientist, Women’s College Research Institute Director, Familial Breast Cancer Research Unit, Women's College Research Institute Professor, Dalla Lana School of Public Health, University of Toronto Professor, Department of Medicine Tier 1 Canada Research Chair in Breast Cancer University of Toronto

Dr. Narod

Steven Narod, MD, FRCPC, FRSC
Senior Scientist, Women’s College Research Institute
Director, Familial Breast Cancer Research Unit, Women’s College Research Institute
Professor, Dalla Lana School of Public Health, University of Toronto
Professor, Department of Medicine
Tier 1 Canada Research Chair in Breast Cancer
University of Toronto

MedicalResearch.com: What is the background for this study? What are the main findings? 

Response: In the past we have shown that about 3 percent of women with ductal carcinoma in situ (DCIS) will die of breast cancer within 20  years of diagnosis.   In the current study, we took a very close look at how the different treatments impact on the risk of dying of breast cancer.

Women with DCIS are at risk for  both a new cancer within the breast and dying of breast cancer from cells that spread beyond the breast (lung, liver, brain and bone).   About 20% of DCIS patients will get a new breast cancer within the breast at 20 years.

  • We show here that it is not necessary to develop a new cancer within the breast to die of breast cancer,  in some cases the DCIS spreads directly in the absence of local recurrence.
  • We show that radiotherapy can prevent 25% of the deaths from breast cancer after DCIS. And this has nothing to do with local recurrence.
  • We show that mastectomy reduces the chance of a getting a new cancer (local recurrence) but  doesn’t reduce the chance of dying of breast cancer.

So, if the goal is to prevent new cancers in the breast –   then mastectomy is the best treatment

If the goal is to prevent the woman from dying of breast cancer – then radiotherapy is the best treatment.  Continue reading

Radionuclide 177Lu-Dotatate Improves QoL in Patients with Neuroendocrine Tumors

MedicalResearch.com Interview with:

Jonathan Strosberg MD Moffitt Cancer Center Tampa, FL

Dr. Strosberg

Jonathan Strosberg MD
Moffitt Cancer Center, Tampa, FL

MedicalResearch.com: What is the background for this study?

Response: Neuroendocrine tumor (NET) progression is associated with deterioration in quality of life. We assessed the impact of 177Lu-Dotatate treatment on time to deterioration in health-related quality of life in patients with advanced midgut neuroendocrine tumors in the NETTER-1 study.

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Adjuvant vs Early-Salvage Postprostatectomy Radiotherapy for Prostate Cancer

MedicalResearch.com Interview with:

Jason Alexander Efstathiou, D., PH.D Director, Genitourinary Division, Department of Radiation Oncology Clinical Co-Director, The Claire and John Bertucci Center for Genitourinary Cancers Multidisciplinary Clinic Massachusetts General Hospital

Dr. Efstathiou

Jason Alexander EfstathiouD.PH.D
Director, Genitourinary Division
Department of Radiation Oncology
Clinical Co-Director, The Claire and John Bertucci Center for Genitourinary Cancers Multidisciplinary Clinic
Massachusetts General Hospital

MedicalResearch.com: What is the background for this study? What are the main findings?

 Response: When surgery has probably failed to cure a patient, the best prospective data supports the use of postoperative radiation therapy.

The debate now centers on the optimal timing of such post-prostatectomy radiation therapy; is it adjuvant (ART) for all (with adverse pathologic features) or early salvage (ESRT) for some (who experience biochemical failure)?

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Radiation Therapy Plus Checkpoint Inhibitors Did Not Increase Adverse Events in Metastatic Lung Cancer

MedicalResearch.com Interview with:

Florence K Keane MD Resident, Radiation Oncology Harvard Radiation Oncology Program Boston, Massachusetts

Dr. Keane

Florence K Keane MD
Resident, Radiation Oncology
Harvard Radiation Oncology Program
Boston, Massachusetts

MedicalResearch.com: What is the background for this study?

Response: Checkpoint inhibitors (CPIs) have recently transformed the management of patients with metastatic lung cancer, demonstrating significant improvements in overall and progression-free survival in both the first-line setting in patients with increased expression of PD-L1 (≥50%) and in patients with previously treated NSCLC who have progressed on chemotherapy. CPIs are also moving into the treatment of patients with localized lung cancer, with the recently published PACIFIC trial demonstrating a significant improvement in progression-free survival in patients with inoperable stage III NSCLC treated with adjuvant durvalumab after definitive chemoradiotherapy.

However, CPIs are associated with unique toxicities as compared to cytotoxic chemotherapy, including pulmonary, endocrine, neurologic, gastrointestinal, and dermatologic adverse events, which may be fatal in some cases. The risk of autoimmune pneumonitis with checkpoint inhibitors is estimated to be on the order of 5%. Many patients with lung cancer will require radiotherapy for palliation of symptoms. Thoracic radiotherapy (TRT) is also a risk factor for pneumonitis, with a dose- and volume-dependent impact on risk. However, it is unknown whether treatment with CPIs and TRT is associated with increased risk of toxicity.

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Stereotactic Radiation Therapy Achieves Superior Results in Some Brain Tumors

MedicalResearch.com Interview with:

Professor Rakesh Jalali, MD Professor of Radiation Oncology President, Indian Society of Neuro-Oncology Tata Memorial Parel, Mumbai India

Dr. Jalali

Professor Rakesh Jalali, MD
Professor of Radiation Oncology
President, Indian Society of Neuro-Oncology
Tata Memorial
Parel, Mumbai India 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Randomized controlled trials to test the efficacy of radiotherapy techniques are challenging to perform. High-precision conformal techniques such as stereotactic radiosurgery/radiotherapy, intensity modulated radiotherapy (IMRT) and particle therapy, etc have been incorporated into routine clinical practice including for brain tumors without always being supported by level-1 evidence.

We therefore conducted a prospective, randomized, controlled trial of stereotactic conformal radiotherapy compared to conventional radiotherapy in young patients with residual/progressive bening and low grade brain tumors requiring radiotherapy for optimal disease control.

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Targeted Radiosurgery Beats Whole Brain Radiation For Brain Tumor Survival

MedicalResearch.com Interview with:

N. Scott Litofsky, M.D. Chief of the Division of Neurological Surgery University of Missouri School of Medicine

Dr. N. Scott Litofsky,

N. Scott Litofsky, M.D.
Chief of the Division of Neurological Surgery
University of Missouri School of Medicine

MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Radiosurgery is being used more often for treatment of brain metastases to avoid potential side effects of whole-brain radiation, such as cognition and mobility impairment. After surgical resection of a brain metastases, some radiation treatment is generally needed to control brain disease. Few studies have directly compared efficacy of tumor control between surgery followed by whole-brain radiation and surgery followed by radiosurgery.

Our objective was to compare outcomes in two groups of patients – one whose brain metastasis was treated with surgery followed by whole-brain radiation and one whose surgery was followed by radiosurgery to the post-operative tumor bed.

We found that tumor control was similar for both groups, with survival actually better in the radiosurgery group. The complications of treatment were similar.

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Fall in PSA Best Predictor of Mortality After Prostate Cancer Treatment

MedicalResearch.com Interview with:

Trevor Royce MD MS
Resident, Harvard Radiation Oncology Program

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Clinical trials in early prostate cancer take more than a decade to report on.

Multiple early reporting endpoints have been proposed, but which one is best, remains unknown, until now. Of all the possible early endpoints examined, to date, how low a PSA blood test falls to, after treatment with radiation and hormonal therapy, appears to be the best, specifically, if the PSA doesn’t get below half a point, that patient is very likely to die of prostate cancer if given standard treatment for recurrence.

Those men deserve prompt enrollment on clinical trials in order to properly save their life.

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Adjuvant Radiotherapy May Benefit Elderly ER- Breast Cancer Patients

MedicalResearch.com Interview with:
Emily C. Daugherty, MD
Upstate Medical University
Radiation Oncology Resident, PGY-4

MedicalResearch.com: What is the background for this study?

Response: Adjuvant radiation following breast conserving surgery has been well
established in the management of early-stage breast cancer as it has
been shown to decrease the incidence of ipsilateral breast tumor
recurrences and also reduce breast cancer mortality. Large prospective
trials have shown for elderly patients with favorable, ER positive
pathology, omission of radiation after lumpectomy can be considered.

However, women with ER negative disease were typically not included in
these trials and given their higher risk for relapse as well as lack of
effective endocrine therapy, we hypothesized that adjuvant radiation
would benefit women over 70 years with early-stage, ER negative tumors.

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Post-Op Radiotherapy Improved Survival In Oral Cavity and Oropharyngeal Squamous Cell Carcinoma

MedicalResearch.com Interview with:

Michelle M. Chen, MD/MHS Department of Otolaryngology- Head and Neck Surgery Stanford University

Dr. Michelle Chen

Michelle M. Chen, MD/MHS
Department of Otolaryngology- Head and Neck Surgery
Stanford University 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: The benefit of post-operative radiotherapy (PORT) for patients with T1-T2 N1 oral cavity and oropharyngeal cancer without adverse pathologic features is unclear. Starting in 2014, the national guidelines no longer recommended consideration of post-operative radiotherapy for N1 oropharyngeal cancer patients, but left it as a consideration for N1 oral cavity cancer patients. We found that post-operative radiotherapy was associated with improved survival in both oral cavity and oropharyngeal cancers, particularly in patients younger than 70 years of age and those with T2 disease.

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Mibefradil Dihydrochoride with Hypofractionated Radiation for Recurrent Glioblastoma

MedicalResearch.com Interview with:

Nataniel Lester-Coll, MD Chief Resident in Radiation Oncology at Yale New Haven, Connecticut

Dr. Nataniel Lester-Coll

Nataniel Lester-Coll, MD
Chief Resident in Radiation Oncology at Yale
New Haven, Connecticut 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Recurrent Glioblastoma Multiforme (GBM) has limited treatment options and the prognosis is poor. Mibefradil diydrochloride was identified using a high-throughput compound screen for DNA double stranded break repair inhibitors. Mibefradil was found to radiosensitize GBM tumor cells in vitro and in vivo. Based on these findings, we sought to determine the maximum tolerated dose of mibefradil and radiation therapy in a Phase I recurrent GBM study. Eligible patients with recurrent  Glioblastoma Multiforme received Mibefradil over a 17 day period, with hypofractionated radiation (600 cGy x 5 fractions). There are 18 patients currently enrolled who have completed treatment. Thus far, there is no clear evidence of radionecrosis. A final dose level of 200 mg/day was reached as the maximum tolerated dose. The drug was very well tolerated at this dose. We saw intriguing evidence of enhanced local control in selected cases. Patients enrolled in a translational substudy who received Mibefradil prior to surgery were found to have adequate levels of Mibefradil in resected brain tumor tissue.

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STAMPEDE Trial: Radiation Therapy Reduced Prostate Cancer Relapses

Prof Nicholas James STAMPEDE Trial Chief Investigator Director of the Cancer Research Centre Warwick Medical School University of Warwick Coventry and Professor of Clinical Oncology Cancer Centre, Queen Elizabeth Hospital Birmingham

Prof. Nicolas James

MedicalResearch.com Interview with:
Prof Nicholas James
STAMPEDE Trial Chief Investigator
Director of the Cancer Research Centre
Warwick Medical School
University of Warwick Coventry and
Professor of Clinical Oncology
Cancer Centre, Queen Elizabeth Hospital
Birmingham

Medical Research: What is the background for this study? What are the main findings?

Dr. James: The STAMPEDE trial is a multi-arm, multi-stage trials platform testing a range of different therapies in addition to standard of care (SOC) for men commencing long term androgen deprivation therapy (ADT) for newly diagnosed locally advanced or metastatic prostate cancer. These data from the control arm form part of a pair of publications detailing outcomes in the control arm of STAMPEDE and help to make sense of the forthcoming paper on the randomised comparisons currently in press at the Lancet.

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Outcomes of Shorter Radiation Therapy for Prostate Cancer Reported

Luca Incrocci, MD, PhD Department of Radiation Oncology Erasmus MC-Daniel den Hoed Cancer Rotterdam, The Netherlands

Prof. Incrocci

MedicalResearch.com Interview with:
Luca Incrocci, MD, PhD
Department of Radiation Oncology
Erasmus MC-Daniel den Hoed Cancer
Rotterdam, The Netherlands 

Medical Research: What is the background for this study? What are the main findings?
Dr.Incrocci: The trial was designed in 2005-2006. The rationale was to reduce the number of fractions and therefore increase patient’s comfort. At that moment some preliminary data was available on the sensitivity of prostate cancer cells to a higher does per fraction.

Our calculations brought us to choose this new fractionation schedule.

The hypofractionation arm (19×3.4 Gy/3 times per week) has shown equivalence in outcome compared to the conventional treatment (39×2 Gy/5 times per week) at a follow-up of 5 yrs. Toxicity is comparable, with a slight increase in bowel complaints at 5yrs. Patients will be followed-up to 10yrs.

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Shorter Palliative Radiation Therapy May Benefit Debilitated Patients

MedicalResearch.com Interview with: Dr. Kavita Vyas Dharmarajan M.D., M.Sc Assistant Professor Radiation Oncology Assistant Professor Geriatrics and Palliative Medicine Icahn School of Medicine at Mount Sinai Medical Research: What is the background for this study? Dr. Vyas Dharmarajan: Forty to fifty percent of all patients having radiation therapy as part of cancer treatment are having the treatment for palliative reasons – meaning, not to cure the cancer but rather to alleviate or prevent symptoms caused by it. The most common reason for referral to a radiation oncologist in the setting of advanced cancer is for alleviation of pain or prevention of an impending fracture due to bone metastases. Radiation therapy is very effective at relieving pain; in fact, published response rates are about 60-80%. The standard treatment has been two weeks of radiation treatment, and this is a common treatment scheme followed by many radiation oncologists. This may be too long or burdensome for some patients given their overall state of illness, or other personal or logistical factors. Several large randomized trials have shown that shorter radiation courses, even as short as 1 fraction of treatment, can be just as effective as 10 fractions (or, two weeks) of treatment. However, literature suggests that these condensed approaches are underutilized by radiation oncologists. A major disadvantage of traditional 2-week courses of radiation is that patients who are very debilitated may be kept in the hospital to undergo this treatment. Some patients stop early because it is too burdensome. Moreover, some may not survive long enough after the treatment to appreciate its benefits. At Mount Sinai, we proposed an intervention that combined the technical expertise within radiation oncology with the whole-patient support services of palliative medicine into a service model led by a single radiation oncologist specializing in the care of advanced cancer patients and collaboration with experts in palliative care. The service model was meant to care for patients suffering from advanced cancer with the goal of improving the quality of care that these patients receive. About two years into the establishment of this new model, we assessed patient outcomes of pain improvement, length of hospitalization, utilization of palliative care services after radiation, treatment completion rates, and duration of treatments. To accomplish this study, we reviewed the charts of 336 consecutively treated patients who underwent radiation therapy at the Mount Sinai Hospital over the last 5 years. We compared the outcomes of the patients treated before the model was established in 2013 to those treated after the model was established. Medical Research: What are the main findings? Dr. Vyas Dharmarajan: We found large differences in quality of care for advanced cancer patients being treated for symptomatic bone metastases after establishment of our palliative radiation oncology consult service. The rate of short-course treatments (meaning 5 or fewer radiation fractions) rose from 26% to 61%, while the corresponding rate of traditional length treatments (meaning, treatments over 5 fractions) declined from 74% to 39%. Hospital length of stay declined by 6 days, from 18 to 12 days (median). We also found that more patients were finishing their treatments -- the proportion of treatments left unfinished halved, from 15% to 8%. More patients were accessing palliative care services within 30 days of finishing radiation, (34% vs. 49%). We did not see a significant change in the proportion of patients experiencing pain relief from the treatment. In fact, we saw a slight improvement (74% to 80%), but this was not a statistically significant increase. Medical Research: What should clinicians and patients take away from this report? Dr. Vyas Dharmarajan: Our study validates the importance of cohesive collaboration in cancer care. The palliative radiation oncology service model thrives at the Mount Sinai Hospital because of the unique and strong partnership between palliative care and radiation oncology departments. Yet, there are elements of palliative care practice that can transcend other disciplines including radiation oncology. These include eliciting and attending to goals, preferences, expectations, and concerns of patients and families being evaluated for treatment. Shorter treatment courses for advanced cancer patients are effective, and the implications of using such treatments goes beyond that of just finishing the treatment early. Patients treated within our service model were more likely to finish their treatment and spend 6 more days at home with their families. Clinicians should know that using such an approach did not compromise the efficacy of the treatment. Medical Research: What should patients know about your study? Dr. Vyas Dharmarajan: Patients should know that their voices, their preferences, and their goals matter when making decisions about palliative radiation treatment. My goal as a palliative radiation oncologist is to engage patients and their families to set realistic expectations and incorporate their goals and preferences into their treatment plans. By involving key players in this process, such as palliative care specialists, we can ensure that patients receive the best quality of care that treats the whole person, not just a tumor. Medical Research: What recommendations do you have for future research as a result of this study? Dr. Vyas Dharmarajan: Our study showed that making small changes to everyday practice in the real world can lead to large impacts on patient outcomes in a population of cancer patients who are often the sickest. Our next projects revolve around 1) how best to equip radiation oncologists with the skills needed to appropriately provide treatment and primary palliative care to advanced cancer patients, and 2) to empower patients and families to engage with their physicians in discussions about their treatment including their overall goals and preferences. Both of these concepts ultimately have direct impacts on treatment recommendations and treatment outcomes for advanced cancer patients and their families. Citation: upcoming Palliative Care abstract: A palliative radiation oncology consult service’s impact on care of advanced cancer patients with symptomatic bone metastases.MedicalResearch.com Interview with:
Dr. Kavita Vyas Dharmarajan M.D., M.Sc
Assistant Professor Radiation Oncology
Assistant Professor Geriatrics and Palliative Medicine
Icahn School of Medicine at Mount Sinai

Medical Research: What is the background for this study? 

Dr. Vyas Dharmarajan: Forty to fifty percent of all patients having radiation therapy as part of cancer treatment are having the treatment for palliative reasons – meaning, not to cure the cancer but rather to alleviate or prevent symptoms caused by it. The most common reason for referral to a radiation oncologist in the setting of advanced cancer is for alleviation of pain or prevention of an impending fracture due to bone metastases.

Radiation therapy is very effective at relieving pain; in fact, published response rates are about 60-80%. The standard treatment has been two weeks of radiation treatment, and this is a common treatment scheme followed by many radiation oncologists. This may be too long or burdensome for some patients given their overall state of illness, or other personal or logistical factors.

Several large randomized trials have shown that shorter radiation courses, even as short as 1 fraction of treatment, can be just as effective as 10 fractions (or, two weeks) of treatment. However, literature suggests that these condensed approaches are underutilized by radiation oncologists. A major disadvantage of traditional 2-week courses of radiation is that patients who are very debilitated may be kept in the hospital to undergo this treatment. Some patients stop early because it is too burdensome. Moreover, some may not survive long enough after the treatment to appreciate its benefits.

At Mount Sinai, we proposed an intervention that combined the technical expertise within radiation oncology with the whole-patient support services of palliative medicine into a service model led by a single radiation oncologist specializing in the care of advanced cancer patients and collaboration with experts in palliative care. The service model was meant to care for patients suffering from advanced cancer with the goal of improving the quality of care that these patients receive. About two years into the establishment of this new model, we assessed patient outcomes of pain improvement, length of hospitalization, utilization of palliative care services after radiation, treatment completion rates, and duration of treatments. To accomplish this study, we reviewed the charts of 336 consecutively treated patients who underwent radiation therapy at the Mount Sinai Hospital over the last 5 years. We compared the outcomes of the patients treated before the model was established in 2013 to those treated after the model was established.

Medical Research: What are the main findings?

Dr. Vyas Dharmarajan: We found large differences in quality of care for advanced cancer patients being treated for symptomatic bone metastases after establishment of our palliative radiation oncology consult service. The rate of short-course treatments (meaning 5 or fewer radiation fractions) rose from 26% to 61%, while the corresponding rate of traditional length treatments (meaning, treatments over 5 fractions) declined from 74% to 39%. Hospital length of stay declined by 6 days, from 18 to 12 days (median). We also found that more patients were finishing their treatments — the proportion of treatments left unfinished halved, from 15% to 8%. More patients were accessing palliative care services within 30 days of finishing radiation, (34% vs. 49%). We did not see a significant change in the proportion of patients experiencing pain relief from the treatment. In fact, we saw a slight improvement (74% to 80%), but this was not a statistically significant increase.

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No Definitive Biomarker Predicts Cancer Response To Radiation Therapy

MedicalResearch.com Interview with:
Dr Ananya Choudhury

Consultant and Honorary Senior Clinical Lecturer, Clinical Oncology
The Christie NHS Foundation Trust,
Wilmslow Road
Withington, Manchester, UK

Medical Research: What is the background for this study? What are the main findings?

Response: Although more than half of newly diagnosed cancer patients are treated with radiotherapy, it is still not possible to select patients who will respond and tolerate radiotherapy compared to those who do not. There has been a lot of work done to try and isolate intrinsic biomarkers which will identify either radio-responsive or radio-resistant disease. We have undertaken a systematic view summarising the evidence for biomarkers as predictors of radiotherapy.

Despite identifying more than 500 references during a systematic literature search, we found only twelve studies which fulfilled our inclusion criteria. Important exclusion criteria included pre-clinical studies, studies with no control population and a sample size of less than 100 patients.

Only 10 biomarkers were identified as having been evaluated for their radiotherapy-specific predictive value in over 100 patients in a clinical setting, highlighting that despite a rich literature there were few high quality studies suitable for inclusion. The most extensively studied radiotherapy predictive biomarkers were the radiosensitivity index and MRE11; however, neither has been evaluated in a randomised controlled trial. Continue reading

Prostate Cancer: Does Timing of Radiation Therapy Affect Outcome?

MedicalResearch.com Interview with:
Timothy N. Showalter, MD, MPH
Associate Professor & Residency Program Director
Department of Radiation Oncology
University of Virginia School of Medicine

Medical Research: What is the background for this study? What are the main findings?

Dr. Showalter: Early radiation therapy has been shown to be an effective curative treatment for prostate cancer patietns with a rising PSA blood test after radical prostatectomy and for men with locally advanced prostate cancer who are at high risk of recurrence after prostatectomy. Despite evidence that radiation therapy is more effective when delivered early (or when the PSA is low), radiation therapy delivery is often delayed to allow more time for patients to recover urinary and sexual function. In order to provide evidence regarding whether delaying radiation therapy does reduce the risks of side effects of treatment, my colleagues and I evaluated outcomes of for a large cohort of patients who received treatment in the Emilia Romagna Region of Italy. We identified a total 0f 9,786 prostate cancer patients who received prostatectomy, including 22% of whom received post-prostatectomy radiation therapy. We found that earlier delivery of radiation therapy was not associated with increased risk of any adverse events, including gastrointestinal, urinary or sexual complications.

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Non-Adherence to Guidelines May Lead To Inappropriate Radioactive Iodine Treatment for Thyroid Cancer

Sanziana Roman MD FACS Professor of Surgery Duke University  Section of Endocrine Surgery Director of the Endocrine Surgery Fellows and Scholars Program Duke University School of Medicine Chief, General Surgery and Associate Chief of Surgery for Clinical Affairs, DVAMCMedicalResearch.com Interview with:
Sanziana Roman MD FACS

Professor of Surgery Duke University
Section of Endocrine Surgery
Director of the Endocrine Surgery Fellows and Scholars Program
Duke University School of Medicine
Chief, General Surgery and Associate Chief of Surgery for Clinical Affairs, DVAMC

Medical Research: What is the background for this study?

Dr. Roman: Adjuvant radioactive iodine (RAI) is commonly used in the management of differentiated thyroid cancer. The main goals of adjuvant RAI therapy are to ablate remnant thyroid tissue in order to facilitate long-term follow-up of patients, decrease the risk of recurrence, or treat persistent and metastatic lesions.

On the other hand, Adjuvant radioactive iodine ( therapy is expensive, with an average cost per patient ranging between $5,429.58 and $9,105.67. It also carries the burden of several potential complications, including loss of taste, nausea, stomatitis with ulcers, acute and/or chronic sialoadenitis, salivary duct obstruction, dental caries, tooth loss, epiphora, anemia, neutropenia, thrombocytopenia, acute radiation pneumonitis, pulmonary fibrosis, male infertility, and radiation-induced malignancies. Therefore, Adjuvant radioactive iodine ( should be used only for appropriately selected patients, for whom the benefits would outweigh the risks.

Based on current guidelines, adjuvant RAI is not recommended for patients with papillary thyroid cancers confined to the thyroid gland when all foci are ≤1 cm (papillary thyroid microcarcinoma, or PTMC). Similarly, Adjuvant radioactive iodine ( does not have a role in the treatment of medullary and anaplastic thyroid cancer. Given the fact that variation in treatments exist, our goal was to analyze patterns of inappropriate adjuvant RAI use in the U.S. in order to identify potential misuses leading to an increase of costs for the healthcare system and unnecessary patients’ exposure to risks of complications.
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Breast Cancer: Intraoperative vs Whole Breast Radiotherapy

Prof Jayant S Vaidya PhD Clinical Trials Group, Division of Surgery and Interventional Science University College London, London, UKMedicalResearch.com Interview with:
Prof Jayant S Vaidya PhD
Clinical Trials Group, Division of Surgery and Interventional Science
University College London, London, UK


MedicalResearch.com: What are the main findings of the study?

Dr. Vaidya: The main findings are

  • a) these are longer term results that have confirmed our original publication in 201
  • (b) We found that when TARGIT intraoperative radiotherapy is given at the time of lumpectomy for breast cancer, the local control and survival from breast cancer is similar to several weeks of whole breast radiotherapy
  • c) we also found that with TARGIT there are significantly fewer deaths from other causes – i.e., fewer deaths from cardiovascular causes and other cancers

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Pancreatic Cancer: Short Course Radiation May Benefit Elderly Patients

MedicalResearch.com Interview with: Dr. Raphael Yechieli
Department of Radiation Oncology at Henry Ford Hospital in Detroit:

MedicalResearch.com: What are the main findings of the study?

Dr. Yechieli:  The main findings of the study are that elderly patients with pancreatic cancer who also have significant co-morbidities can still be safely and effectively treated with a short course of radiation treatment. Furthermore, the local control and survival data from our study are similar to previously published data, where patients were treated with more intense and longer courses of treatment.

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