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New Study Finds Selective Nodal Radiation More Effective In Treating Cancer

A new study conducted by researchers at the University of Colorado Cancer Center has revealed that the frequency with which certain cancers come back can be brought down to a certain degree by irradiating certain set of lymph nodes near the tumour rather than all of them together. The study was published in Nature Communications.

Commenting on the study findings, Sana Karam, MD, PhD, associate professor of radiation oncology at the University Of Colorado School Of Medicine and the study's senior author, said "Doctors have traditionally irradiated all the lymph nodes surrounding a tumor in a process called elective nodal irradiation. But the problem with this scorched-earth approach in the era of immunotherapy is that doing so also eliminates the source of immune cells for the immunotherapy to work on. Lymph nodes are the hub for priming and expanding the major immune cells that can go and fight the cancer."

Through the study, researchers understood that irradiating all the lymph nodes around a tumor brought down immune memory and antigen spread, thus leading to a larger risk of the cancer going to areas far away from where it originated.

The team tested this theory pre-clinically on different tumor models of head and neck, along with a breast cancer and melanoma model. The result was the same, irrespective of the type of cancer that was being treated. When radiation killed the immune cells, which could recognize what the cancer looked like, the body's immune system was not able to fight the cancer systemically.

As part of the study, researchers also found that removing certain lymph nodes known as sentinel lymph nodes was very necessary as the failure to remove those will result in the cancer cells occurring once again.

The findings of the study were supported by data from a recently conducted human patient clinical trial where pre-surgical radiation was restricted to the main tumor and the sentinel lymph nodes while skipping all other lymph nodes in order to sustain immune memory. Researchers found that the immune system in these patients was very active, which is synonymous with a better prognosis.

Karam concluded, "We're hopeful that this data will set the stage for future clinical trial design, not only reducing patients' side effects but also improving long-term outcomes."

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