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Standardized planning, standardized treatment
16.05 PDT Sunday: Joined-up thinking on IMRT is the headline theme of a study carried out at the University of Pittsburgh School of Medicine, PA. The results, which are being presented as a poster at the ASTRO meeting this week, demonstrate that IMRT for head-and-neck cancer can be uniformly delivered across a large healthcare network of academic and community cancer clinics with the help of a centralized planning and treatment process.
“Our study demonstrates that it is feasible for head-and-neck cancer patients to receive IMRT in their own communities without sacrificing high-quality care,” said Dwight Heron, associate professor of radiation oncology, University of Pittsburgh School of Medicine and director of radiation oncology, University of Pittsburgh Medical Center. “This is possible through an integrated network in which treatment is standardized across all cancer centres.”
IMRT treatment planning for the centres was performed at one main location, D3 Radiation Planning, located in Pittsburgh. With the help of telemedicine capabilities, however, medical physicists based at D3 were able to collaborate with radiation oncologists at community locations to develop individualized treatment plans for the patients.
According to the study results, there were no significant differences in toxicity profiles and treatment outcomes in 604 head-and-neck cancer patients treated with IMRT at 12 community cancer centres and one flagship academic facility.
The results show that 248 patients (41%) were treated at the flagship facility, and 356 patients (59%) received IMRT at one of the community centres. All 13 centres, connected through a telemedicine network, followed the same clinical pathway guidelines for the radiotherapy management of head-and-neck cancer, which included specific details on volumes for radiation treatment planning and recommended doses of IMRT.
When the investigators compared outcomes between the academic centre and the community centres, they found that there were no significant differences between survival or recurrence rates.
“By standardizing planning and treatment for IMRT, patients who live in remote locations can benefit from the same quality of care available at a large National Cancer Institute-designated comprehensive cancer centre,” said Heron. “Bringing advanced radiation therapy to community locations can have a very positive effect on a patient’s quality of life by relieving the anxiety and stress of travelling for treatment.”
Further reading
A K Bhatnagar et al. 2007 Outcomes analysis of IMRT for treatment of head and neck cancers in a large NCI-designated integrated cancer center network Proc. 49th Annual ASTRO Meeting: Int. J. Radiat. Oncol. Biol. Phys. 69 3 S552.
