High-dose radiation therapy improves survival in formerly incurable cancer patients

Results of a new randomized, phase II clinical trial have demonstrated an aggressive form of precision radiation therapy can increase the lifespan of oligometastatic cancer patients and doubles how long they can live without cancer, according to the American Society for Radiation Oncology (ASTRO).

“Traditionally, when a patient had a cancer that spread to other parts of their body—such as to their bones or brain—they were considered to be incurable,” said lead author David Palma, MD, PhD, with the research institute of London Health Sciences Center (LHSC), in the release. “Now, we’ve been able to show, for the first time in a randomized trial, that high-dose radiation can effectively treat these limited recurrences, and we’ve been able to increase survival by a median of 13 months.”

In the randomized, open-label study—SABR-COMET—Palma and colleagues enrolled 99 patients from four countries who had been treated for cancer, which later returned with tumors in up to five various locations.

All patients had a life expectancy of more than six months. In 92 patients, the disease had spread to one to three new sites, according to the study.

Patients were randomized at a 1:2 ratio into two separate groups: palliative standard of care treatments (SOC) and SOC with stereotactic ablative radiotherapy body (SABR) for metastatic lesions. Median follow-up time was 27 months.

Overall, those who received SABR lived “considerably” longer with a median overall survival of 41 months, compared to the 28 months for patients in the SOC group. Additionally, stereotactic radiation doubled the time patients survived without cancer growth from six to 12 months.

“Stereotactic radiation therapy can increase how long these patients live and how long they live without their cancer coming back, and it doesn’t seem to have a detrimental impact on their quality of life,” Palma said in the release.

The authors did note 30 percent of those treated with more aggressive radiation felt negative side effects compared to the nine percent of patients who received standard treatment.

“Ultimately, the question of whether an oncologist will offer this treatment as the standard of care for oligometastatic patients will be up to that oncologist,” Palma said. “At the very least, physicians should be considering this as a treatment option for their patients.”

The findings will be presented at the 60th Annual ASTRO meeting next week.