April 21, 2015

Study Shows Effectiveness of Novel Radiation Therapy Technique

A newly published study shows total skin irradiation (TSEI) using a dual-beam rotational technique matches or improves upon conventional TSEI techniques in treating cutaneous T-cell lymphoma (CTCL).

Winship radiation oncologist and senior author, Mohammad K. Khan, MD, PhD, DABR, says these results represent one of the largest rotational total skin electron irradiation (RTSEI) clinical outcomes studies to date. Khan’s study, “Total Skin Electron Therapy for Cutaneous T-Cell Lymphoma Using a Modern Dual-Field Rotational Technique,” with first author, Thatcher Heumann, BA, a medical student at Emory, is published in the May 2015 issue of the International Journal of Radiation Oncology • Biology • Physics, a special edition of the Red Journal devoted entirely to lymphoma on the 50th anniversary of the first multidisciplinary lymphoma conference in Paris in 1965.

"Our findings show that the dual-beam rotational technique is an effective treatment for advanced cutaneous T-cell lymphoma skin lesions of all types," says Khan, assistant professor and medical student clerkship director in the Department of Radiation Oncology at Winship Cancer Institute of Emory University. "It is an excellent option for CTCL patients, providing additional hope where other lines of topical and systemic therapies have failed. Emory's Winship Cancer Institute is one of the few places in the state of Georgia that offers this technique."

Until now, the clinical outcomes of rotational total skin electron irradiation have been largely unknown and infrequently used. As a leader in RTSEI, Dr. Khan and his colleagues examined the clinical response of CTCL patients treated at Emory from 2000 to 2013 using the rotational technique to a standard dose (> 30 Gy).

Khan's findings revealed that the response to the treatment matched or improved upon outcomes using conventional total skin irradiation techniques, despite the study's large percent of advanced-stage patients.

When controlling for demographic factors and tumor stage, the study also showed no significant difference in outcomes between white and African Americans, contrary to previous Surveillance, Epidemiology and End Results (SEER) database studies of CTCL indicating poor overall survival in African Americans.

Khan is also a senior author, with resident, Naresh Jegadeesh, MD, as first author, on a second study published in the May lymphoma issue of the Red Journal, titled, "Predictors of Local Recurrence After Rituximab-Based Chemotherapy Alone in Stage III and IV Diffuse Large B-Cell Lymphoma: Guiding Decisions for Consolidative Radiation."

"It's an honor to have two major studies from Winship Cancer Institute accepted in the special lymphoma edition of the Red Journal," says Khan.

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