Below are brief descriptions of research results scheduled for presentation by Johns Hopkins Kimmel Cancer Center scientists at the 2017 Annual Meeting of the American Society for Radiation Oncology (ASTRO), Sept. 24–27, in San Diego.
MODIFIED RADIATION METHOD SHOWN TO DELIVER TREATMENT THAT MAY SPARE CHILDREN HARMFUL EFFECTS [ABSTRACT #60]
As part of a cooperative group trial from the Children’s Oncology Group, Johns Hopkins scientists have shown that a commonly used cancer treatment known as intensity modulated radiation therapy (IMRT) delivered more radiation to tumors and less to normal, healthy surrounding tissues in children with advanced muscle cancers when compared with a less-tailored approach to radiation delivery. The findings, presented at the 2017 ASTRO Annual Meeting, could help decrease the chances of serious side effects of radiation therapy, which are especially worrisome in still-growing children.
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Each year, hundreds of soft tissue sarcomas, or muscle tumors, are diagnosed in children and young adults in the U.S., says study leader Stephanie A. Terezakis, M.D., associate professor of radiation oncology and molecular radiation sciences at the Johns Hopkins University School of Medicine and Kimmel Cancer Center. These tumors are often aggressive, with rapid growth and a high risk of metastasis, requiring equally aggressive treatment.
Standard treatment includes radiation before surgery, a protocol designed to shrink a tumor and reduce the chances that malignant cells will migrate. However, Terezakis explains, radiation is associated with potentially debilitating side effects, including growth deformities, bone fractures and scar tissue that can affect mobility, along with secondary tumor development. Children are particularly sensitive to these side effects, she says, which can affect them over the course of their lives.
Tailoring the radiation dose and target area—delivering just enough to shrink the tumor without significantly affecting surrounding tissues—can minimize the side effects, but it’s been unclear which of several radiation protocols might work best. To better understand the differences among techniques, she and her colleagues compared two main types of radiation treatment for soft tissue sarcomas: 3D conformal radiation therapy (3D-CRT), which uses digital diagnostic imaging, powerful computers and specialized software to conform radiation beams to the shape of the tumor, and IMRT, which delivers radiation patterned to match the shape of the tumor by modifying intensity of the radiation beams.
