By Dr. Todd Pezzi
As oncologists, we are constantly seeking better ways to treat patients. Our goals are to find and incorporate more effective approaches especially for patients and diseases that currently have limited options. We must continuously follow emerging research so that we can be as up to date as possible. In this article we will review some of the most recent developments in the field.
Trials Find SBRT Treatment Effective for Metastatic Cancer
Metastatic cancer refers to cancer that has spread throughout one’s body. According to the National Cancer Institute, metastatic cancer accounts for up to 90 percent of all cancer deaths in the United States on an annual basis.
One of the biggest challenges for patients living with metastatic cancer is having to remain on medications with debilitating side effects. Two recently presented trials demonstrated that a short course of radiation allows some patients to go on extended breaks from these medications.
Both trials deployed a five-day regimen known as stereotactic body radiation therapy, or SBRT. Each trial only included patients with oligometastatic disease, which means these individuals had a limited number of cancer sites present in their bodies.
The randomized “CURB” trial looked at patients with breast and lung cancer. It was discovered that using SBRT to target focused areas of disease led to patients’ cancers progressing less rapidly. This was especially true for patients with lung cancer. The results of this study suggested that these patients could take a break from chemotherapy until there were signs of cancer progression.
The “EXTEND” trial shared similarities but focused on men with prostate cancer. This iteration of the study found that adding focused radiation therapy to standard hormone therapy resulted in slowed cancer progression. This would allow men to take prolonged breaks from hormone therapy.
Breakthroughs in Managing Metastatic Cancer Pain
Another significant challenge for some patients living with cancer is managing their cancer-related pain.
The typical treatment for pancreatic cancer-related abdominal and back pain uses a combination of narcotics along with an invasive procedure called a celiac plexus block. During the procedure, a needle containing an anesthetic medication is injected into abdominal nerves.
Dr. Yaacov Lawrence of Sheba Medical Center, located in Israel, recently demonstrated that targeting these same nerves with a single, focused radiation treatment (SBRT) can achieve the same goal completely non-invasively. Of the 125 patients he treated, over half showed an improvement in their pain levels and reduced their consumption of opioid pain medications.
Beyond pancreatic cancer, the mainstay of treatment for liver cancer, or hepatocellular carcinoma, is surgical removal. Patients who are not candidates for surgery usually just receive chemotherapy, which is often associated with a poor prognosis.
However, a recently reported, international and randomized trial called RTOG-1112 has just explored the effect of adding SBRT to chemotherapy for liver cancer patients. The results of this study revealed that the patients who received SBRT and chemotherapy lived significantly longer than those who received chemotherapy alone.
The Search Never Stops
The studies highlighted above are just some examples of promising findings that will improve our ability to treat patients with cancer. Oncology as a field has made great strides, especially for patients with metastatic cancer. We will continue to search unrelentingly for better solutions and integrate these emerging approaches into our practices.
Dr. Todd Pezzi is a physician at Advocate Radiation Oncology. Advocate Radiation Oncology’s board-certified oncologists provide expert, customized patient care. For more information, please visit AdvocateRO.com.
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