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Latest Research in Head and Neck Cancer

Across the world, radiation oncologists are actively researching safe and effective radiation treatments, including more personalized approaches and studies of lower doses for a variety of cancers. The following research studies were presented during the ASTRO Annual Meeting in Chicago in September 2019. Annually, ASTRO brings together more than 10,000 radiation oncology professionals to share the latest science and provide educational sessions, all designed to improve patient care, support clinical practice and advance science and research in the field of radiation oncology.

It is important to review and discuss all treatment options, including radiation therapy with your primary care physician before determining which option or combination of options is best for you and your lifestyle.

Studies in Head and Neck Cancer

Download PDF of Head and Neck Studies

Radiation de-escalation may be possible in some locally advanced head and neck cancers

Sue Yom, MD, PhD, MAS, of the University of California, San Francisco, recently examined two different de-escalation strategies, treatments which lower the dose of radiation, for patients with human papillomavirus virus (HPV)-positive head and neck cancer. “We tested two approaches to reduce the dose of radiation to a specific group of HPV-positive patients with very limited extent of cancer,” she said.

Dr. Yom and her co-authors hypothesized that reduced-dose radiation therapy would prevent cancer relapse for at least two years in 85% or more of the participating patients. Some patients received radiation therapy only on a slightly compressed schedule, while others received radiation therapy in conjunction with the chemotherapy drug cisplatin.

After more than two years of follow-up, the researchers concluded that the combined radiation-chemotherapy regimen met the two-year progression-free survival goal, but the radiation-only regimen did not. “We designed the two trial arms [segments] hoping they would both be successful, but one was not,” Dr. Yom said. “In light of this and other data showing negative outcomes from de-intensifying treatment, additional studies should be undertaken with caution. However, we are excited to move forward with our successful de-intensification arm in a new large-scale study attempting to develop a new de-intensified standard of care.”

Proton beam therapy offers esophageal cancer patients reduced toxicities versus intensity-modulated radiation therapy

Esophageal cancer is a disease that often reduces a patient’s quality-of-life. The esophagus is the hollow tube that connects your mouth with your stomach. When you swallow food or liquid, it travels through the esophagus to reach your stomach and begins the digestion of food process.

Tumors in the esophagus can make swallowing difficult or impossible, and the radiation treatment used to treat them can also cause sides effects that make swallowing a challenge. When patients receive radiation therapy for esophageal cancer, in addition to treating the cancer, top priorities are preserving patients’ ability to swallow and protecting the nearby heart and lungs from radiation damage.

A Phase II randomized study measured the severity of the side effects of radiation therapy associated with two different types of treatment. Specifically, the study compared the side effects of proton beam therapy (PBT) with those of intensity-modulated radiation therapy (IMRT).

The study, led by Steven H. Lin, MD, PhD, a radiation oncologist at MD Anderson Cancer Center in Houston, hypothesized that the greater precision of PBT could reduce esophageal cancer patients’ total toxicity burden (TTB) without affecting their clinical outcomes, such as progression-free survival (PFS).

Lin, and his team assigned numeric values to 11 side effects that often occur within one year of starting radiation therapy. Severe side effects increased each patient’s TTB score more than mild ones.

The investigators found that, at a median follow-up time of 52.9 weeks, patients in the IMRT group had worse side effects, with an average TTB score that was 2.3 times higher than those in the PBT group. About half the patients in each group had surgery as part of their overall therapy. For these patients, the average complications score after surgery was 7.6 times higher in the IMRT group than in the PBT group. Additional research is being conducted to determine whether PBT or IMRT helps patients live longer; these results will not be available for several years.

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