National Journal Publishes Results of Celilo Cancer Study
Published on 9/28/2007
THE DALLES, Ore. (September 27, 2007) - A study conducted by health professionals at Celilo Cancer Center and recently published in a national medical journal could help alleviate a common side effect of treatment for many breast cancer patients across the country. Those receiving their treatment locally already are benefiting from the Celilo team's efforts.
The study was conducted, and its findings reported, by Celilo's medical director of radiation oncology, Keith Stelzer, M.D, Ph.D., physicist Mark Davidson, dosimetrist Steve Dugick and head therapist Mark Mullins, as well as Beau Bailey, an OSU student intern. It appeared in a recent issue of Medical Dosimetry, a medical journal widely read by radiation therapists and other cancer specialists.
The publication alerted a national audience to the Celilo team's successful efforts to eliminate or reduce an uncomfortable and often painful side effect that many breast cancer patients endure during and after radiation therapy.
"Women who don't undergo a mastectomy and receive radiation to their breast experience redness and often peeling of the skin," says Stelzer. "The peeling can be dry or moist, almost like blistering, and it can be quite painful."
Because of its complex geometry, which varies with each patient, the breast has long challenged cancer specialists trying to determine the most effective dose and distribution of radiation during treatment. With recent advances in CT scanning facilitating more precise three-dimensional planning, cancer teams now are able to more precisely deliver radiation doses evenly throughout the breast. However, little information has existed to help them use these technological advances to address the common skin side effect.
"With new technology we were able to manipulate the radiation beam to achieve more favorable results and analyze the dose we were delivering through the breast," Stelzer explains. "But we didn't know what features of that dose we needed to pay attention to in order to make the treatments most tolerable while still preventing the tumor from coming back."
Beginning in 2005, Celilo's team began its own study in an attempt to compile that information for themselves, then share it with colleagues to help improve the outcomes of breast cancer patients locally and far beyond.
Over the course of the study, the Celilo team analyzed the various dosage levels they delivered to 100 patients and was able to pinpoint the dosage characteristics that held the highest probability of achieving effective treatment with fewer side effects.
"When we had a patient with these side effects, we went back and reviewed her treatment to learn everything we could about her particular dose," says Stelzer. "We used that information to help us predict the dosage characteristics that might be predictive for the redness and peeling we often were seeing."
Stelzer and team then developed treatment standards that focused on two factors -- the volume of radiation patients receive and the maximum dose they can receive before increasing the likelihood of triggering the skin-related side effects.
Not surprisingly, Stelzer says, the study determined that patients with larger body and breast size were most likely to develop severe skin reactions during treatment.
"Fortunately," Stelzer adds, "These also are the patients who are most likely to benefit from our new techniques."
That's positive news for Celilo patients immediately and, over time, patients beyond the region.
"Because no data was available in the past, the small bit of information we gathered winds up being very practical for widespread use," Stelzer says. "Now, cancer practitioners have, for the first time, real information to help them plan the care of their patient so that they minimize any discomfort. This study could have widespread impact."