Less Radiation to Treat Head and Neck Cancers


PITTSBURGH, Pa. (Ivanhoe Newswire)- Head and neck cancers are continuing to increase in the United States, going up about five percent a year due to the prevalence of the human papilloma virus, or HPV. Patients are traditionally treated with surgery, followed by radiation. But now, researchers are testing a lower dose of radiation in some patients and the results may be practice changing.

Transoral robotic surgery, known as TORS, has become a surgeon’s preferred treatment for head and neck cancers, followed by radiation to destroy microscopic cancer cells left behind.

“It turns out that the side effects of radiation are very different than surgery,” Robert Ferris MD, PhD, and director of the UPMC Hillman Cancer Center explains.

(Read Full Interview)

Dr. Ferris and his colleagues conducted a phase two clinical trial, lowering the radiation dose in patients with an intermediate risk of cancer coming back. These patients have cancer that has spread between two and four lymph nodes. The researchers also determine how far outside the lymph node cancer has spread and assign a dose of radiation, either the standard dose of 60 or a lower dose of 50. Reducing the radiation dose from 60 to 50 might not sound like a lot, but it shortens treatment by a full week.

“And it turns out if you ask any cancer patient the first few weeks of radiation are reasonably tolerable, but then it gets progressively harder. And that final week is actually a lot in terms of the short-term acute side effects or toxicity,” Dr. Ferris says.

Researchers found the patients in both groups had survival rates of 95 percent two to three years after surgery and treatment.

“Because it was a pretty good-sized phase two trial, we may actually see that this changes practice in some centers across the U.S.,” Dr. Ferris tells Ivanhoe News.

Dr. Ferris says in the meantime, researchers at UPMC Hillman are looking at additional trials for patients who are considered high risk for recurrence to determine if substituting immunotherapies for standard chemotherapy will reduce side effects for those patients.

Contributors to this news report include: Cyndy McGrath, Executive Producer & Field Producer; Kirk Manson, Videographer; Roque Correa, Editor.

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REPORT:       MB #5008

BACKGROUND: Head and neck cancers usually begin in the squamous cells that line the mucosal surfaces of the head and neck. Places such as inside the mouth, throat, and voice box. These cancers are referred to as squamous cell carcinomas. They can also begin in the salivary glands, sinuses, or muscles or nerves in the head and neck, but these types of cancer are much less common. Squamous cell carcinomas almost always spread locally and/or to the lymph nodes in the neck. Sometimes, cells can be found in the lymph nodes of the upper neck when there is no evidence of cancer in other parts of the head and neck, possibly because the original primary tumor is too small.

(Source: https://www.cancer.gov/types/head-and-neck/head-neck-fact-sheet)

TRANSORAL ROBOTIC SURGERY: Transoral robotic surgery is a procedure to remove mouth and throat cancers in which a surgeon uses a sophisticated, computer-enhanced system to guide the surgical tools. It gives the surgeon an enhanced view of the cancer and surrounding tissue. Using a robotic system to guide the surgical tools allows for more precise movements in tiny spaces and the capability to work around corners. The technology consists of endoscopes, or thin tubes with tiny instruments at the tip attached to robotic arms; a special camera at the tip of a robotic arm that provides enhanced views of the surgical area; and a computer console where the surgeon manages the instruments and camera’s every move. When compared with traditional procedures, transoral robotic surgery tends to result in a quicker recovery and fewer complications for people with mouth and throat cancers.

(Source: https://www.mayoclinic.org/tests-procedures/transoral-robotic-surgery/about/pac-20384803 and https://my.clevelandclinic.org/health/treatments/21612-transoral-robotic-surgery-tors)

NEW COMBO THERAPY FOR HEAD AND NECK CANCER: Researchers at the University of Cincinnati have tested a new combination therapy in animal models looking for a way to make an already effective treatment even better for head and neck cancer. Christina Wicker, PhD, a postdoctoral fellow in the lab of Vinita Takiar, MD, PhD, led the research in hopes it will extend the lives of patients one day. Researchers combined radiation therapy with a drug (telaglenastat) that stops a key enzyme in a cell pathway that becomes altered in cancer cells. This process caused those cells to grow rapidly and resist treatment. They found that the drug in the animal models alone reduced the growth of head and neck cancer cells up to 90 percent, and it also increased the efficacy of radiation in animals with head and neck tumors by 40 percent.

(Source: https://www.sciencedaily.com/releases/2021/01/210122154417.htm)


Cyndy Patton

Senior Manager, Public Relations


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Doctor Q and A

Read the entire Doctor Q&A for Robert Ferris, MD, PhD, Head and Neck Cancer Surgeon

Read the entire Q&A