Rutgers cancer study cites improved survival rate with combo treatment

NEW BRUNSWICK — For decades, doctors have been thinking of ways to reduce the need for radiation therapy on cancer patients.

But newly-published research out of Rutgers Cancer Institute of New Jersey finds the risky treatment option, used after chemotherapy, has resulted in a better survival rate among pediatric patients with stage 1 or 2 Hodgkin lymphoma, versus a treatment plan of chemotherapy only.

Researchers analyzed the cases of 5,657 pediatric patients nationwide. Their analysis showed a five-year survival rate of 94.5 percent among those who received chemotherapy alone. That survival rate bumped up to 97.3 percent for patients who underwent combined modality therapy.

"The fact that you're more likely to be alive five years later if you had treatment including radiation means that not everybody should have radiation eliminated from their therapy," Dr. Peter Cole, study author and chief of pediatric hematology/oncology, told New Jersey 101.5.

Adolescents and young adults showed the most impressive difference with the combined therapy versus chemotherapy alone. The youngest patients, aged 1 to 13, appeared to benefit the least from the combined treatment.

Hodgkin lymphoma, which starts in white blood cells that are part of the body's immune system, is the most common cancer diagnosed in teenagers aged 15 to 19.

Cole said the adolescent group is an "underserved population" in this area; it's the group least likely to be enrolled in a clinical trial.

Most individuals diagnosed with Hodgkin lymphona will be alive and free of disease for several years after their initial diagnosis, Cole said. The study, he noted, does not suggest every person with the disease needs radiation — after all, the survival rate still topped 94 percent for chemo-only patients.

Both chemotherapy and radiotherapy alone are associated with increased risk of toxic effects, researchers said. There's been an emphasis on reducing the number of chemotherapy cycles and perhaps the need for radiation altogether on certain patients.

Cole said it's still too early to determine the "cost" of improved survival rates among the patients analyzed who received radiation as part of their treatment plan. With additional follow-up down the line, it's possible researchers could see these individuals suffering from long-term side effects, including additional cancers.

The data set, which delivered outcome data for patients from 2004 to 2015, also lacked to provide certain prognostic factors, such as the bulk of disease and the number of nodal sites.

"What I hope is that oncologists who read this report think it's as interesting as we do, and use the information to have an informed discussion with each patient and their family," Cole said. "Some people are more scared about the risk of the cancer coming back, and others worry more about the long-term toxicity."