Gynecologic oncology programs in the UM Cancer Network investigate brachytherapy and radiation clinical trials
Brachytherapy, sometimes called internal radiation therapy, has revolutionized the standard of care for patients with endometrial, cervical, or vaginal cancers. Brachytherapy involves placing seeds, ribbons, or capsules that contain a radiation source in or near the tumor using a needle or catheter. "We can often cure gynecologic cancers with brachytherapy," said Gautam Rao, MD, associate professor of gynecologic oncology at the University of Maryland School of Medicine with office locations at University of Maryland Medical Center and University of Maryland Upper Chesapeake Medical Center. "Even patients with advanced gynecologic cancers can often be cured because of brachytherapy."
The University of Maryland Greenebaum Comprehensive Cancer Center (UMGCCC) is participating in ongoing research efforts to refine brachytherapy techniques for gynecologic cancers with the goal of improving outcomes and making the treatment easier on patients, with less time in the hospital and less discomfort.
The current multicenter brachytherapy trial offered through the University of Maryland Cancer Network is A Randomized Phase III Trial of Two Standard Dose Fractionation Regimens for Adjuvant Vaginal Brachytherapy in Early Stage Endometrial Cancer. The vaginal cylinder study for endometrial cancer examines patients who need postoperative treatments after they have had a hysterectomy. It compares a three-treatment regimen with a six-treatment regimen and evaluates long-term toxicity, particularly vaginal stenosis, and general quality of life after treatment.
The UM Cancer Network's gynecologic oncology programs provide comprehensive, streamlined care for patients, including easy access to clinical trials like this one. The expert teams are by each patient's side from screening and diagnosis to consultation, surgery, chemotherapy, and end-of-life care, if needed. Primary care providers or gynecologists refer patients to the team. Gynecologic oncologists stage the cancer and start treatment, and radiation oncologists meet with the patient to discuss radiation and offer the patient participation in this trial.
"We offer a system-wide approach that puts patients first," said Sarah McAvoy, MD, assistant professor of radiation oncology, vice chair of education and residency program director at the University of Maryland School of Medicine. "Our robust clinical trials for gynecologic cancer are just one example of the coordinated care we provide, especially for more complex patients or patients with recurrent disease who require interstitial brachytherapy."
The benefits of gynecologic oncology program at University of Maryland Medical System include:
- Image-based and MRI-directed treatments
- Strong interdisciplinary teamwork and collaboration between gynecologic oncology and radiation oncology to get patients in for consultations quickly and provide seamless multidisciplinary care
- A robust gynecologic brachytherapy program including capability for interstitial therapy
- Expertise in recurrent and complex gynecologic cancers, particularly among the specialists at the Maryland Proton Treatment Center – part of UMGCCC's radiation oncology services (proton therapy can be helpful for patients with complex or recurrent cancers)
- A cancer network where patients and their families can receive high-quality care at their community cancer center and, when needed, have seamless access to the most advanced treatments only available at an NCI-designated comprehensive cancer center
In addition to the brachytherapy trial, the Maryland Proton Treatment Center is also conducting the UPPROACH trial: A Phase 2 study of Upfront Intensity Modulated Proton Beam Therapy (IMPT) and Concurrent Chemotherapy for Post-Operative Treatment in Loco-Regionally Advanced Endometrial Cancer. The UPPROACH study is focused on evaluating whether use of an advance radiation therapy, proton therapy, can be safely and effectively combined with concurrent, full-dose chemotherapy.
Both trials are examples of the University of Maryland Cancer Network's embrace of scientific discovery in patient care. "We're offering the latest treatments and technologies to our patients, continuing to move the field forward," Dr. Rao said. "With these clinical trials, we're ahead of the curve. We're looking at gynecologic oncology through a forward-looking lens: Where is the science taking us, and what can we do that is even better for our patients and their outcomes than we're doing right now?"
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