A clinical trial hosted at the Cincinnati Children’s Hospital Medical Center/UC Health Proton Therapy Center is looking at ways this form of radiation could improve outcomes and quality of life for patients with anal cancer.
Jordan Kharofa, MD, assistant professor in the Department of Radiation Oncology at the University of Cincinnati (UC) College of Medicine, says that anal cancer is one of the most difficult cancers to treat in terms of patients’ side effects. Kharofa, also a UC Health radiation oncologist, initiated and is leading the clinical trial.
“There were 7,270 cases of anal cancer in the U.S. in 2015 and around 1,000 deaths caused by this cancer,” he says. “Current standard treatment for this cancer is typically five weeks of radiation with chemotherapy administered twice during that time, and side effects could include urinary irritability as well as bowel and skin issues; additionally, long-term bowel issues, sexual dysfunction, hip fractures and more could occur as a result of standard radiation.
“The toxicities experienced by anal cancer patients undergoing chemotherapy and radiation are quite challenging. Approximately 60 to 75 percent of patients have moderate to severe side effects. We believe that proton therapy will help us decrease the amount of radiation delivered to outside organs and potentially reduce some of these detrimental effects, both short- and long-term.”
Proton therapy delivers radiation to a tumor area with remarkable precision, sparing healthy tissues. It works by extracting positively charged protons from hydrogen gas and accelerating them through a cyclotron (a particle accelerator) up to nearly two-thirds of the speed of light. The protons are guided to the tumor site by magnetic and electrical fields. They are propelled with just enough energy to reach a precise point in the tumor and then stop before they can harm nearby, uninvolved tissue.
This type of treatment is offered at the Cincinnati Children’s Hospital Medical Center/UC Health Proton Therapy Center, which is also the site of the clinical trial. The center, which opened in August 2016, is one of only 25 in the country and is also the only facility in the world with a gantry (radiation treatment room with a moveable beam) dedicated exclusively to cancer research.
“Patients who are enrolled in this study will complete the same amount of treatment—five weeks of radiation and two chemotherapy treatments during that time—however, the radiation administered will be proton radiation,” he says. “We hope to evaluate the side effects with this treatment after three months, six months and into survivorship.”
Kharofa says a preliminary data-based study conducted by researchers at UC showed positive results for patients so he’s expecting the same in this trial, which will hopefully enroll 20 patients.
“This is a unique trial but one that could greatly help patients with this relatively rare type of cancer,” he says. “This could reduce many of the toxicities patients experience with current standard treatment, and we’re happy to offer proton therapy for patients receiving radiation in the Tristate.”