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University of Pittsburgh Cancer Institute Research Helps Determine Safe Radiation Dosage for Anal Cancer Patients, Lessening Toxicity and Allowing for Continued Treatment

PITTSBURGH, Nov. 4, 2010 – Patients with anal carcinoma who are undergoing intensity-modulated radiotherapy (IMRT) and concurrent chemotherapy experience fewer side effects associated with gastrointestinal toxicity when safe radiation dosage is well-established, according to researchers from the University of Pittsburgh Cancer Institute (UPCI). The results of the research were presented this week at the American Society for Radiation Oncology annual meeting in San Diego.

According to the researchers, the study is important because when patients experience gastrointestinal toxicity, they often need several breaks during their radiation treatment. The treatment breaks allow patients to recover from the toxicities of treatment but unfortunately negatively affect clinical outcomes.

The study, led by S. Gillianne DeFoe, M.D., chief resident of radiation oncology with UPMC Cancer Centers, and overseen by Sushil Beriwal, M.D., associate professor of radiation oncology with the University of Pittsburgh School of Medicine and director of  the Department of Radiation Oncology at Magee-Womens Hospital of UPMC, reviewed the treatment of 58 patients with anal cancer who were treated with chemotherapy concurrently with IMRT at UPMC Cancer Centers between March of 2003 and March of 2009.

“While the treatment options for patients with anal cancers have come a long way, they can still be quite debilitating,” said Dr. DeFoe. “IMRT is one of the most advanced treatment options we can offer patients, but in order for this technique to be effectively utilized, we need to set guidelines for its use. By reviewing the cases of patients who came through UPMC Cancer Centers in the last six years, we determined that if we can limit the dose of small bowel radiation to a certain volume, we can further reduce the toxicity of treatment.”

According to the study, clinical factors such as a patient’s age and stage of disease could not determine whether or not a patient would experience gastrointestinal toxicity from this combination of treatments. However, they found that by exceeding the small bowel dose beyond the threshold volume, the rate of gastrointestinal toxicity quadrupled.

The identification of optimal IMRT dosimetric parameters can help guide radiation oncologists across the country and internationally in treating patients with anal cancer who must receive concurrent IMRT and chemotherapy.

This study was funded by the Department of Radiation Oncology, University of Pittsburgh Cancer Institute.

As the only NCI-designated comprehensive cancer center in western Pennsylvania, UPCI is a recognized leader in providing innovative cancer prevention, detection, diagnosis and treatment; bio-medical research; compassionate patient care and support; and community-based outreach services. UPCI investigators are world-renowned for their work in clinical and basic cancer research.

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