Radiation Found To Be More Effective Than Surgery At Preventing Second Larynx Cancers In Patients Treated For Early Larynx Cancer

Main Category: Cancer / Oncology
Also Included In: Radiology / Nuclear Medicine
Article Date: 16 Nov 2007 - 12:00 PDT

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Researchers from Loyola University Medical Center have recently reported on the safety and efficacy of two treatment options commonly recommended to patients with early larynx cancer.

The largest and only study of its kind examined a total of 3898 patients from a NCI sponsored national database who underwent either surgery or radiation. The lead investigator, Dr. Gopal Sachdeva concluded that long term cure rates were equivalent with both of these options. In addition, there was no increased risk of second cancers among patients who received radiation compared to the surgical control. More importantly, surgical management of these patients resulted in a long term statistically significant increased risk of developing a second laryngeal cancer which radiation appears to protect against. This, according to Dr. Sachdeva, "can be explained by a concept called 'field cancerization.'"

"Whatever the etiological factor, cigarette smoking or alcohol, genetic changes can occur in different areas of the aerodigestive resulting in precancerous and cancerous changes." According to Dr. Sachdeva, "In the case of larynx cancer, radiation treats a larger area, essentially the entire voice box. Surgery however usually just addresses the site of the tumor." "Thus," Dr. Sachdeva concludes, "radiation likely eliminates microscopic areas of precancerous changes in the field that if left untreated can progress to new second cancers - a new concept he has coined as 'field sterilization'" The authors concluded that because of equivalent long term survival, when deciding on a treatment for patients with early laryngeal cancer these finding as well as final voice quality deserve greater consideration.

Dr. Sachdeva is currently a Resident in Radiation Oncology at Loyola University Medical Center. He received his MD with a Distinction in Research from SUNY Downstate in Brooklyn, New York. He has a tremendous interest in the field of Secondary Malignancies and is conducting several other studies on Second Cancers in cancer survivors. "Second Cancers, as a group are now the sixth most common cancer in the country, behind Skin, Prostate, Breast, Lung and Colorectal. We now have over 10.5 million cancer survivors and over 10% are predicted to develop a second cancer." According to Dr. Sachdeva, "Studies on preventative therapies and on key molecular alterations to be used as targets for gene therapy need to be explored further to help alleviate this crisis."

The study was presented recently at the 49th Annual Scientific Meeting of the American Society for Therapeutic Radiology and Oncology (ASTRO) .

American Society for Therapeutic Radiology and Oncology