Is Radiotherapy Ineffective on Forms of Secondary Cancer?

A widely reported study suggests that “‘whole brain radiotherapy’ is of no benefit to people with lung cancer which has spread to the brain.

Media outlets ran with articles which gave credence to a UK study on the subject.

Researchers found that radiotherapy did not significantly increase survival times and quality of life when compared with standard care.

The study investigated advanced lung cancer, and found that the cancer has a poor survival rate; approximately nine weeks regardless of treatment.

Providing whole brain radiotherapy alongside standard care added only about an extra 4-5 days of life when adjusted for quality of life, yet often resulted in such issues as hair loss and nausea.

The study was carried out by researchers from the Northern Centre for Cancer Care, Newcastle Hospitals NHS Foundation Trust, University College London, and other institutions in the UK and Australia.

Based on a randomised controlled trial, scientists involved in the research aimed to discover whether whole brain radiotherapy affects quality of life and overall survival in people with non-small cell lung cancer that has spread to the brain.

Funding was provided by Cancer Research UK and the Medical Research Council Clinical Trials Unit at University College London in the UK, and the National Health and Medical Research Council in Australia.

The study was published in the peer-reviewed journal The Lancet on an open access basis, and thus is available for free online.

Dr Paula Mulvenna, one of the study’s authors, suggested that there has been little progress in the treatment of this form of cancer in decades, despite new methods having been developed.

“In our lung cancer clinics, we were not seeing the improvements we had hoped for in our patients. Survival times are poor and have hardly changed since the 1980s. What’s more, the technique’s toxicity can be substantial and it can damage cognitive function”.

However, it is still believed that radiotherapy is of benefit in treating non-small cell lung cancer which has not spread to the brain.

The researchers stated that although their findings show whole brain radiotherapy didn’t give inferior or poorer outcomes than standard care.

“The combination of the small difference in QALYs and the absence of a difference in survival and quality of life between the two groups suggest that whole brain radiotherapy provides little additional clinically significant benefit for this patient group”.

Overall, the results suggest that this treatment approach may need to be reconsidered for people with cancer that has spread to the brain and a poor life expectancy.


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