Chemo-radiotherapy

This report discusses the benefits of using chemo-radiotherapy, a combination of chemotherapy and radiation therapy, over single therapies like chemotherapy or radiation therapy. It provides high-quality care to the cancer patient, enhances the chances of overall treatment, and reduces the probability of injury to other organs. The report also highlights the benefits of chemo-radiotherapy in treating head and neck cancer, esophagus cancer, lung cancer, breast cancer, and rectal cancer.

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Chemo-radiotherapy
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Table of Contents
Introduction.................................................................................................................................................2
Discussion................................................................................................................................................2
Conclusion...................................................................................................................................................6
References...................................................................................................................................................8

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Introduction
Cancer is the life threating disorder that affects people from all around the world, and
there are different types of treatment available according to the type of Cancer the person has.
Two of the most important cancer therapies include chemotherapy and radiotherapy (Siegel,
Miller, and Jemal, 2016).in the Chemotherapy treatment is specific drugs are used that are
designed in such a way that kills the cells that are responsible to cause cancer problems (DeVita,
and Chu, 2008). On the other hand, the radiotherapy uses extremely advanced technology in
order to deliver the targeted beams of radiation to destroy the cancer cells. However, both the
treatment strategies have different side effects (Jones, et al., 2011). The combination of
chemotherapy and radiation therapies called chemo-radiotherapy are designed in a way to cure
the body and stop the cancer cell progression. It has been studied that a single therapy is less
effective than the two therapies used at the same time (van Hagen et al., 2012). In this particular
assessment report, the advantages of using the combined therapy of chemotherapy and radiation
therapy will be discussed.
Discussion
The combinations therapy is basically the use of two different therapies at the same time
to treat a patient (Scheer, Fakiris, and Johnstone, 2011). The combination of two therapies
provides the clinicians to deliver high-quality care and encounter the health target already set for
the patient (Park et al., 2015). In several cases, the combination therapy not only enhances the
chances of treatment or long term benefits bit also decreases the injury to the different vital
organs and the tissues of the body in a single strategy. For example in the osteosarcoma, a bone
cancer that happens mostly in adults, the surgical amputation was the only treatment previously.

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The combined treatment of chemotherapy and radiation therapy is commonly able to kill cancer
deprived of essential loss of the limb. Likewise in case of early-stage breast cancer commonly
treated by removing the tumor and nearby tissues with the radiation therapy. In past, this type of
cancer was treated by removing the whole breast from the body along with the nearby lymph
nodes and other tissues and It was the only option to treat cancer (Scheer, Fakiris, and Johnstone,
2011).
A single type of therapy sometimes turns the tumor more vulnerable to the second type.
Some type of chemotherapy medicines can enhance the tumor's vulnerability to radiation
treatment. On other scenarios the drugs works collaboratively each improves the others' strength;
therefore their combined efficacy is higher than would be expected by their specific impact. The
combinations of various chemotherapy agents are commonly applied to shut off the cancer
escape ways (Ohe, 2005). During the last two decades, joining chemotherapy and radiation has
transformed the face of cancer management. Some chemotherapy mediators assist explain
radiation so that it performs well, and deliver a complete effect in totaling to the native result of
the radiation, possibly stopping or postponing metastasis. If the high amounts of either modality
are desired, it is occasionally possible to apply a lesser dose of each to achieve the similar
outcomes, but with inferior toxicity or the necessity for less (or no) operation (Klopp, and Eifel,
2011).
In numerous cases, the adding of chemotherapy to radiation therapy, in fact, leads to
enhancements in general survival versus simply using radiation only. The indication of joining
drugs with the radiation is not completely new (Pepek, Chino, Willett, Palta, Blazer III, Tyler,
Uronis, and Czito, 2013). Investigators first investigated with the joint therapies more than 50

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years before, and an initial trial directed at the Mayo Clinic in Rochester presented that directing
chemotherapy and radiation concurrently enhanced the efficiency of radiation and might, in
certain illustrations, be remedial for diseased persons with pancreatic, colorectal and abdominal
cancer. In 1979, investigators in England took this indication further and advanced a philosophy
about the collaboration of radiation therapy and chemotherapy (Pepek, et al., 2011). Named
“spatial cooperation,” the theory planned that the accomplishment of radiation and
chemotherapeutic medicines is focused toward dissimilar target locations in the human body and
work individually of one another. Radiation lean towards to target restricted tumors, though
chemotherapy medications are probable to be additionally effective in removing micro-
metastases (Pepek, et al., 2011).
A study conducted by Klienberg, Gibson, and Forastiere (2007) on the use of chemo-
radiotherapy in esophageal cancer revealed that the combined therapy of radiation and
chemotherapy is more effective in esophageal cancer than the single therapies. They further
revealed that in esophagectomy in patients with the squamous cell histology the quality of life
and the survival is superior with the use of concurrent external-beam radiotherapy and the four-
medicine chemotherapy regimens when matched to the surgeries they had previously. They
further stated that the early studies if the surgery only for the curative management of esophageal
cancer, many decades of the trials comprising chemo-radiotherapy has established the clinical
and pathological effects of this combined therapy. A report published by Shapiro, Van Lanschot,
Hulshof, van Hagen, van Berge Henegouwen, Wijnhoven, van Laarhoven, Nieuwenhuijzen,
Hospers, Bonenkamp, and Cuesta (2015) also supported that fact that this strategy is beneficial in
esophagus cancer. They further stated that the long term results of the study established that the

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neo-adjuvant chemo-radiotherapy following surgery must be the standard of management for the
patient having resectable esophageal or the esophagogastric junction Cancer.
With at least five years of follow-ups, outcomes displayed that the patients assigned to
the neo-adjuvant chemoradiotherapy before the surgical experienced complete and progression-
free survival advantages compared to the individuals had surgery only. The study comprised 368
individuals with resectable and esophageal junction carcinoma. The cancer patient was randomly
assigned to the chemo-radiotherapy of 5 weeks cycle followed by the surgery alone. The results
of that study showed complete advantages in five years overall survival among the neoadjuvant
patient group (Shapiro et al., 2015).
O'Rourke, I Figuls, Bernadó, and Macbeth, (2010) conducted a study among 2728
participants with non- small cell lung cancer. They selected the patient with stage 1-3 NSCLC
taking radial radiotherapy and to receive concurrent chemo-radiotherapy verses the radiotherapy
alone. Their main results revealed that the chemo-radiotherapy significantly decreased the
complete risk of death and complete progression-free survival at any location.
Including the chemo-radiotherapy in the treatment of the patients with head and neck
cancer is beneficial. The concurrent chemotherapy combined with radiotherapy (chemo-
radiotherapy) is now acknowledged to enhance outcome in chronic head and neck cancer
patients matched with once-routine radiotherapy only and has turned into a standard strategy for
the non-metastatic disorder (Harari, 2005). Additionally, the combination of chemotherapy to
radiotherapy subsequent surgery for the resectable head and neck tumor with high-risk aspects
shows enhanced locoregional management and disorder-free survival. Though, in both the
conclusive and post-operative head and neck malignancy, the improved survival results are

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conveyed by an increase in overall handling toxicity cases. The randomized trials with the
chemo-radiotherapy signify important progress in head and neck malignancy. However, many
queries remain unrequited, not least of which is the precise chemo-radiotherapy program to
recommend outside the setting of controlled clinical trials (Harari, 2005).
Haddad, O'Neill, Rabinowits, Tishler, Khuri, Adkins, Clark, Sarlis, Lorch, Beitler, and
Limaye, (2013), conducted a study among the previously untreated, non-metastatic, and newly
diagnosed adult patients with head and neck cancer. The results of that study showed that the
survival of individuals in the chemo-radiotherapy only group in that investigation was an
unpredictably good parallel to the chemotherapy simply. Though, their investigation also
presented that including the induction chemotherapy with the chemo-radiotherapy was healthier
than concurrent chemo-radiotherapy only in locally chronic head and neck malignancy (Haddad
et al., 2013).
Conclusion
Cancer is the leading cause of death and affects people from all around the world. There
are different therapies available to treat the malignancy-related issues and chemo-radiotherapy is
one of them. It is a combination of chemotherapy and radiation therapy. There are different
benefits of using combined therapy over single therapies like chemotherapy or radiation therapy.
It basically provides a high quality of care to the cancer patient; enhance the chances of overall
treatment and reducing the probability of injury to other organs. Previously the only treatment
for osteosarcoma was surgical amputation but including the combined therapy provides enhances
results in that particular disease. The single therapy might make the disease more vulnerable but
by using the chemo-radiotherapy the chances of successful treatment are more favorable. It shut

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off the escape routes of cancer and kills the cancer cells. Some of the cancer types that can be
treated well compared to the single type of cancer therapies include head and neck cancer,
esophagus cancer, lung cancer breast cancer, and rectal cancer. The results of the cancer patient
after five years receiving chemo-radiotherapy are more enhanced than the patient received a
single type of treatment. Therefore it can be said the combined therapy has the long term benefits
and reduces the repeated cancer issues after getting the treatment.

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References
DeVita, V.T. and Chu, E., 2008. A history of cancer chemotherapy. Cancer research, 68(21),
pp.8643-8653.
Haddad, R., O'Neill, A., Rabinowits, G., Tishler, R., Khuri, F., Adkins, D., Clark, J., Sarlis, N.,
Lorch, J., Beitler, J.J. and Limaye, S., 2013. Induction chemotherapy followed by concurrent
chemoradiotherapy (sequential chemoradiotherapy) versus concurrent chemoradiotherapy alone
in locally advanced head and neck cancer (PARADIGM): a randomised phase 3 trial. The lancet
oncology, 14(3), pp.257-264.
Harari, P.M., 2005. Promising new advances in head and neck radiotherapy. Annals of
Oncology, 16(suppl_6), pp.vi13-vi19.
Jones, C.U., Hunt, D., McGowan, D.G., Amin, M.B., Chetner, M.P., Bruner, D.W., Leibenhaut,
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term androgen deprivation for localized prostate cancer. New England Journal of
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Kleinberg, L., Gibson, M.K. and Forastiere, A.A., 2007. Chemoradiotherapy for localized
esophageal cancer: regimen selection and molecular mechanisms of radiosensitization. Nature
Reviews Clinical Oncology, 4(5), p.282.
Klopp, A.H., and Eifel, P.J., 2011. Chemoradiotherapy for cervical cancer in 2010. Current
oncology reports, 13(1), pp.77-85.

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Ohe, Y., 2005. Chemoradiotherapy for lung cancer. Expert opinion on pharmacotherapy, 6(16),
pp.2793-2804.
O'Rourke, N., I Figuls, M.R., Bernadó, N.F. and Macbeth, F., 2010. Concurrent
chemoradiotherapy in non‐small cell lung cancer. Cochrane Database of Systematic Reviews,
(6).
Park, S.H., Sohn, T.S., Lee, J., Lim, D.H., Hong, M.E., Kim, K.M., Sohn, I., Jung, S.H., Choi,
M.G., Lee, J.H. and Bae, J.M., 2015. Phase III trial to compare adjuvant chemotherapy with
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Pepek, J.M., Chino, J.P., Willett, C.G., Palta, M., Blazer III, D.G., Tyler, D.S., Uronis, H.E. and
Czito, B.G., 2013. Preoperative chemoradiotherapy for locally advanced gastric
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Scheer, R.V., Fakiris, A.J. and Johnstone, P.A., 2011. Quantifying the benefit of a pathologic
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Shapiro, J., Van Lanschot, J.J.B., Hulshof, M.C., van Hagen, P., van Berge Henegouwen, M.I.,
Wijnhoven, B.P., van Laarhoven, H.W., Nieuwenhuijzen, G.A., Hospers, G.A., Bonenkamp, J.J.
and Cuesta, M.A., 2015. Neoadjuvant chemoradiotherapy plus surgery versus surgery alone for
oesophageal or junctional cancer (CROSS): long-term results of a randomised controlled
trial. The lancet oncology, 16(9), pp.1090-1098.

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Siegel, R.L., Miller, K.D. and Jemal, A., 2016. Cancer statistics, 2016. CA: a cancer journal for
clinicians, 66(1), pp.7-30.
van Hagen, P., Hulshof, M.C.C.M., Van Lanschot, J.J.B., Steyerberg, E.W., Henegouwen,
M.V.B., Wijnhoven, B.P.L., Richel, D.J., Nieuwenhuijzen, G.A.P., Hospers, G.A.P.,
Bonenkamp, J.J. and Cuesta, M.A., 2012. Preoperative chemoradiotherapy for esophageal or
junctional cancer. New England Journal of Medicine, 366(22), pp.2074-2084.