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Better radiation treatment approach

Jun 3, 2013

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In the first study of its kind, Sunnybrook researchers report that for patients with bone metastases undergoing a second round of radiation therapy for recurrent pain, single-fraction radiation treatment in one day is as effective and with less side effects, than multiple-fraction treatment over 5 days.

Results of this large, randomized study conducted by the NCIC Clinical Trials Group at Queen's University were presented at this year's American Society of Clinical Oncology (ASCO) Annual Meeting. The trial involved 850 patients from 9 countries.

"We want to continue to provide efficacious pain management strategies for patients with cancers that have spread to the bone. In tandem with better chemotherapies that are helping patients live longer, for those who still require pain relief after first radiation treatment, we now know that a single-fraction, second treatment is as effective as multiple-fraction second treatment, offering these patients similar pain control but with less side effects," says Dr. Edward Chow, lead investigator and radiation oncologist, Sunnybrook's Odette Cancer Centre, and professor, Department of Radiation Oncology, University of Toronto, Canada.

The researchers report that benefit from radiation therapy was observed in 45 per cent of evaluable patients who received single-fraction, second radiation treatment (8 Gy in a single day). Benefit from radiation therapy was observed in 51% of evaluable patients who had multiple-fraction second treatment (20 Gy over 5 days). Based on these data, assessments of how pain interfered with daily activities, and evaluations of quality of life, the investigators concluded that the single treatment was as good as the more complex multiple day treatment.

While benefit from radiation therapy was similar for both groups and overall survival was the same, the researchers report significantly increased side effects for patients who had multiple-fraction treatment over 5 days. Side effects included skin reddening, nausea, lack of appetite, vomiting and diarrhea.

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Full media release

SINGLE RADIATION TREATMENT EFFECTIVE FOR RECURRENT PAIN

Toronto, ON (June 2, 2013, 8:00 a.m. CDT) - In the first study of its kind, Sunnybrook researchers report that for patients with bone metastases undergoing a second round of radiation therapy for recurrent pain, single-fraction radiation treatment in one day is as effective and with less side effects, than multiple-fraction treatment over 5 days.

Results of this large, randomized study conducted by the NCIC Clinical Trials Group at Queen's University were presented at this year's American Society of Clinical Oncology (ASCO) Annual Meeting. The trial involved 850 patients from 9 countries.

"We want to continue to provide efficacious pain management strategies for patients with cancers that have spread to the bone. In tandem with better chemotherapies that are helping patients live longer, for those who still require pain relief after first radiation treatment, we now know that a single-fraction, second treatment is as effective as multiple-fraction second treatment, offering these patients similar pain control but with less side effects," says Dr. Edward Chow, lead investigator and radiation oncologist, Sunnybrook's Odette Cancer Centre, and professor, Department of Radiation Oncology, University of Toronto, Canada.

The researchers report that benefit from radiation therapy was observed in 45 per cent of evaluable patients who received single-fraction, second radiation treatment (8 Gy in a single day). Benefit from radiation therapy was observed in 51% of evaluable patients who had multiple-fraction second treatment (20 Gy over 5 days).  Based on these data, assessments of how pain interfered with daily activities, and evaluations of quality of life, the investigators concluded that the single treatment was as good as the more complex multiple day treatment.

While benefit from radiation therapy was similar for both groups and overall survival was the same, the researchers report significantly increased side effects for patients who had multiple-fraction treatment over 5 days. Side effects included skin reddening, nausea, lack of appetite, vomiting and diarrhea.

Participants in the study were diagnosed with cancer that had spread to bones, most often from prostate, breast and lung cancers. Median age was 65 years with 59% male patients and 41% female patients.

Overall median survival was 8 months for both single-fraction treatment and multiple-fraction treatment patients.

Approximately 50 per cent of radiation treatments across all disease sites are for the purposes of symptom management for patients with advanced cancers.

The study was made possible through NCIC CTG's grant funding from the Canadian Cancer Society Research Institute. The NCIC CTG also receives grant funding support from the U.S. National Cancer Institute.

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For more information, please contact:

Natalie Chung-Sayers, 416.480-4040, natalie.chung-sayers@sunnybrook.ca

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