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I found a comparison of Intensity Modulated Radiation Therapy (IMRT) with Conventional Radiotherapy (CRT) for UPSC

lindaprocopio's picture
lindaprocopio
Posts: 2022
Joined: Oct 2008

There was recently some discussion on whether there were any benefits for using the more costly IMRT as opposed to the conventional radiation for external pelvic radiation. Since I started IMRT today, I did some research this afternoon and came across this article that seems to justify seeking IMRT as your external radiation choice if you have an option:

Comparison of Intensity Modulated Radiation Therapy (IMRT) with Conventional Radiotherapy (CRT) for Treatment of Uterine Papillary Serous Carcinoma (UPSC) with Sequential Carboplatin and Paclitaxel

Chemotherapy: A Toxicity Study
J. Vainshtein, S. Mutyala, N. Thawani, R. Hannan, R. Yaparpalvi, S. Kalnicki
Department of Radiation Oncology, Albert Einstein College of Medicine, Bronx, NY

Purpose/Objective(s): Uterine papillary serous carcinoma (UPSC) is an uncommon, aggressive variant of endometrial carcinoma that has a propensity for abdominal and pelvic failures and a poor response to therapy. The combination of chemotherapy with radiation therapy (RT) has improved cure rates in patients with UPSC, although with substantial acute toxicity. The development of IMRT has facilitated the delivery of radiation to tumor while sparing normal organs, allowing for good local control with the potential for reducing toxicity. Our institute has initiated a ‘‘sandwich protocol’’ for the treatment of UPSC, consisting of sequential chemotherapy both before and after RT. We herein report a comparison of the acute toxicities from IMRT and CRT in conjunction with high dose rate brachytherapy and ‘‘sandwich’’ Cisplatin or Carboplatin and Paclitaxel (CT) in the treatment of UPSC.

Materials/Methods: Between January 2000 and March 2008, 52 patients with histologically proven UPSC were accrued to the IRB approved ‘‘sandwich’’ protocol at our institution. All patients underwent surgical staging laparotomy with total abdominal hysterectomy and bilateral salpingoophorectomy, followed by sequential chemotherapy and RT. This consisted of Paclitaxel (175 mg/m2) and either Cisplatin (75 mg/m2) or Carboplatin (AUC=6.0, 6.5, 7.5) every 21 days for 3 cycles, both before and after RT. In October 2005, the protocol was amended to change the RT delivery from CRT to IMRT.

Results: The initial 24 patients were treated with CRT and the subsequent 27 patients were treated with IMRT. Two patients in each group were treated to extended paraaortic lymph node fields per protocol for lymph node involvement. All patients in the IMRT group and 20/23 pts in 3DCRT group received intracavitary HDR brachytherapy. All patients completed their prescribed course of RT. No patients in either group experienced any grade 4 toxicity. Patients treated with IMRT experienced significantly less grade 2 or greater gastrointestinal toxicity (30.4% vs. 3.7%, p = 0.007), as well as less genitourinary toxicity (8.3% vs. 0%, p = 0.13) than did those treated with CRT. No differences in hematologic or skin toxicity between treatment groups were observed.

Conclusions: Radiation in combination with sandwich CT chemotherapy for UPSC had less toxicity when delivered via IMRT compared to CRT. This difference was statistically significant for GI toxicity, and approached statistical significance for GU toxicity.
The reduction in GI toxicity is of particular importance, as GI complications are a common dose limiting toxicity in UPSC patients. Further follow-up and prospective study with dose escalation is warranted.

Author Disclosure: J. Vainshtein, None; S. Mutyala, None; N. Thawani, None; R. Hannan, None; R. Yaparpalvi, None; S. Kalnicki,
None.

( http://download.journals.elsevierhealth.com/pdfs/journals/0360-3016/PIIS0360301608017008.pdf )

california_artist
Posts: 850
Joined: Jan 2009

That was very interesting. It would have been fantastic if they had also reported how everyone was currently doing as a result of the treatment, although their objective was only to do a comparison of treatments which they did do.
I do hope your legs are less swollen and all is well with you.
Love and hope,

Claudia

bonniesue
Posts: 126
Joined: Apr 2009

I had searched the internet and am glad you shared. I know you have started the IMRT and it helped that you said they marked a little different than the tattoos. It was a source of worry for me. My mom seems to be tolerating the IMRT with some fatigue and loose stool(always carries some Imodium). Your post always help and good thoughts and prayers to you as you start your IMRT therapy--one of the radiation oncologist told me to think of it as a cure with some strong sunshine, poison to cancer as chemo, and surgery to snip it out. bonnie sue

roebe
Posts: 2
Joined: Jun 2009

Both machine are good enough but i think Conventional Radiotherapy (CRT) is much better. It can regulate and cure fasten our body in pain. A lot on oncologist advise this kind of therapy, it can easily admit to patients. This patients differentiate this therapy and it found the comparison each other.

lindaprocopio's picture
lindaprocopio
Posts: 2022
Joined: Oct 2008

Can you elaborate a little bit? We are always interested in the opinions of oncologists and radiation professionals, and I'm not sure what you're saying here. Thanks!

roebe
Posts: 2
Joined: Jun 2009

This is true that radiation therapy may cause some negative if the operation to the patient is more use of it. But in other way a lot of patient cure in this kind of machine like this said radiation therapy. Im proud that a lot of people cure cancer in such way that able tto use this kind of radiation therapy although it is our option to seek treatment.

lindaprocopio's picture
lindaprocopio
Posts: 2022
Joined: Oct 2008

These 2 posts leave me more confused than ever. They are obviously posted by the same person, and yet include links to 2 different photos and radiation oncologists. I just don't get it.

Ladies: anyone else understand this thread better than I do? If so, can you help me out here?

lindaprocopio's picture
lindaprocopio
Posts: 2022
Joined: Oct 2008

These 2 posts leave me more confused than ever. They are obviously posted by the same person, and yet include links to 2 different photos and radiation oncologists. I just don't get it.

Ladies: anyone else understand this thread better than I do? If so, can you help me out here?

deanna14
Posts: 733
Joined: Oct 2008

I don't even have pictures, and the posts are diffucult to read????

kkstef's picture
kkstef
Posts: 706
Joined: May 2008

I agree....I could not figure it out either. In checking the profile, there really is no info there either...????

lindaprocopio's picture
lindaprocopio
Posts: 2022
Joined: Oct 2008

If you click on the last couple words of each of these posts, each is a LINK to a different website (both very similar) and each features a different oncologist, but neither is research or anything, just an advertisement-type website. I would so LOVE to have an oncologist posting with us, but I think we're being scammed here somehow.

deanna14
Posts: 733
Joined: Oct 2008

It would be nice to have oncologist on here, but that would probably be too much of a liability for them.

Songflower's picture
Songflower
Posts: 632
Joined: Apr 2009

It would be wonderful to have a site like www.breastcancer.org. They post research (studies interpreted by oncologist), treatments, tips, and meet the experts in which you can attend conferences and send in questions. What a dream that would be! Sometimes dreams come true! The specialists speak in the conferences and don't seem to worry about liability. They keep the lectures archived. We're a smaller group but it would still be a great thing to have.

Your CSN Staff's picture
Your CSN Staff
Posts: 200
Joined: May 2008

You are correct about being spammed. We have inactivated several accounts that have been created to spam the CSN boards with links to different physicians listed on a particular website. However, when I inactivate an account, the posts and any replies to them are also deleted. So this time, I deleted the links that were embedded and have blocked the 4 new accounts that have been created to spam us. Please flag posts you come across that include ads or anything at all that you question.

Thanks,
Greta

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