Irish team makes cancer treatment breakthrough

Breakthrough research by an Irish cancer team is likely to have global implications for the manner in which radiotherapy treatment is delivered to some patients, according to doctors leading the clinical trial.

Currently, patients with advanced cancer can suffer from the painful and paralysing effects of spinal cord compression when cancer spreads to the backbone — for which decompression surgery, combined with radiotherapy, is the current standard of care. Surgery is often ruled out due to the frailty of patients and radiotherapy routinely involves five-day treatments.

However, the Irish research project has found that a large single dose of radiotherapy produces the same outcome as the longer course of treatment, making treatment easier on the patient and less expensive to deliver.

The results are regarded as so significant, that they have been unveiled at the Astro annual meeting, the world’s premier Radiology Oncology Scientific Conference in San Francisco, where the Irish submission was in the “top four” of more than 2,800 submissions, according to Professor John Armstrong, director of research at St Luke’s Radiation Oncology Network (SLRON), Dublin.

Prof Armstrong, a co-investigator in the nine-year clinical trial which involved Ireland’s five main radiotherapy departments, said the results of their project were “immediately translatable” on the ground because they required no training to implement and no change of infrastructure, effectively changing overnight how cancer treatment is delivered in relation to spinal cord compression.

“It means that we can give a single large dose [of radiotherapy] and it means treatment becomes more feasible for weak and debilitated patients. In cost terms, we are talking about reducing the number of visits to the radiation machine by 80%, which is a huge resource saving,” he said.

The result of the larger single dose showed equivalent ability to alleviate the condition, preserving the patient’s ability to walk, postponing the onset of paralysis, and generally alleviating pain, suffering and incontinence.

Spinal cord compression occurs when cancer spreads to the backbone and then spreads internally and the tumour presses on the nerves to the legs, causing paralysis and incontinence.

Prof Armstrong said that “unfortunately, some of the most common cancers, such as lung, prostate and breast cancer, have a tendency to spread”.

Despite their illness, it was the “willingness of patients” and a “good research infrastructure” that had helped provided “the meaningful results” now attracting worldwide attention, he said.

The project’s principal investigator, French-trained radiation oncologist Dr Pierre Thirion, who’s also a member of SLRON, said the research has the potential to change clinical practice worldwide.

“The management and treatment of malignant spinal cord compression is a common daily clinical challenge and is a devastating condition, associated with a poor individual patient functional outcome and a short lifespan. “Our research has demonstrated that a convenient, cheaper treatment can be just as good as a more expensive prolonged therapy,” Dr Thirion told the plenary session of the international conference.