Correcting tiny differences in patient's position for radiotherapy could increase survival chances

April 21, 2018

Barcelona, Spain: Very small differences in the way a patient lies during radiotherapy treatment for lung or oesophageal cancer can have an impact on how likely they are to survive, according to research presented at the ESTRO 37 conference.

These differences of only a few millimetres can mean that the radiation treatment designed to target patients' tumours can move fractionally closer to the heart, where it can cause unintentional damage and reduce survival chances.

The finding suggests that survival could be improved by tightening up treatment guidelines to ensure patients are positioned more accurately.

Radiotherapy plays an important role in cancer care in, amongst others, hard to treat tumours such as lung and oesophageal cancer. However, it can cause side-effects and previous research shows that radiotherapy to the chest can have negative long-term effects on the heart, for example, increasing the risk of heart disease.

When planning radiotherapy treatment, cancer specialists create a CT image of their patient. This reveals the exact position and size of the tumour within the body. At each subsequent treatment, another image is created and used to check that the patient and, therefore, the tumour is in the same position, within a certain threshold, before the treatment is delivered.

The new research was presented by Corinne Johnson, a medical physics PhD student at the Manchester Cancer Research Centre, part of the Christie NHS Foundation Trust and the University of Manchester, UK.

She and her colleagues studied a group of 780 patients with non-small cell lung cancer who were treated with radiotherapy. For each treatment, patients were positioned on the treatment machine and an image was taken to confirm that they lay within 5mm of their original position. They used the data from these images to gauge how accurately the radiotherapy dose was delivered over the course of treatment, and whether it was shifted slightly closer or slightly further away from the patient's heart.

When they compared these data with how likely patients were to survive, they found that patients with slight shifts towards their hearts were around 30 per cent more likely to die than those with similar sized shifts away from their hearts.

When they repeated the research with a group of 177 oesophageal cancer patients, they found an even greater difference of around 50 per cent. In both groups the pattern of survival remained even when researchers took other factors such as the patient's age into account.

Johnson explains: "We already know that using imaging can help us to target cancers much more precisely and make radiotherapy treatment more effective.

"This study examines how small differences in how a patient is lying can affect survival, even when an imaging protocol is used. It tells us that even very small remaining errors can have a major impact on patients' survival chances, particularly when tumours are close to a vital organ like the heart.

"By imaging patients more frequently and by reducing the threshold on the accuracy of their position, we can help lower the dose of radiation that reaches the heart and avoid unnecessary damage."

Johnson and her colleagues are now looking at the data in more detail to see whether particular regions of the heart are more sensitive to radiation than others, and they hope to investigate the effect of differences in patient position in other types of cancer.

President of ESTRO, Professor Yolande Lievens, head of the department of radiation oncology at Ghent University Hospital, Belgium, said: "Radiotherapy treatments are given according to strict protocols to ensure that patients get the most effective treatment with the fewest possible side-effects. This research suggests that changes to lung and oesophageal cancer protocols could positively impact the overall survival of patients with these cancers, both of which have relatively high mortality rates."
-end-


European Society for Radiotherapy and Oncology (ESTRO)

Related Cancer Articles from Brightsurf:

New blood cancer treatment works by selectively interfering with cancer cell signalling
University of Alberta scientists have identified the mechanism of action behind a new type of precision cancer drug for blood cancers that is set for human trials, according to research published in Nature Communications.

UCI researchers uncover cancer cell vulnerabilities; may lead to better cancer therapies
A new University of California, Irvine-led study reveals a protein responsible for genetic changes resulting in a variety of cancers, may also be the key to more effective, targeted cancer therapy.

Breast cancer treatment costs highest among young women with metastic cancer
In a fight for their lives, young women, age 18-44, spend double the amount of older women to survive metastatic breast cancer, according to a large statewide study by the University of North Carolina at Chapel Hill.

Cancer mortality continues steady decline, driven by progress against lung cancer
The cancer death rate declined by 29% from 1991 to 2017, including a 2.2% drop from 2016 to 2017, the largest single-year drop in cancer mortality ever reported.

Stress in cervical cancer patients associated with higher risk of cancer-specific mortality
Psychological stress was associated with a higher risk of cancer-specific mortality in women diagnosed with cervical cancer.

Cancer-sniffing dogs 97% accurate in identifying lung cancer, according to study in JAOA
The next step will be to further fractionate the samples based on chemical and physical properties, presenting them back to the dogs until the specific biomarkers for each cancer are identified.

Moffitt Cancer Center researchers identify one way T cell function may fail in cancer
Moffitt Cancer Center researchers have discovered a mechanism by which one type of immune cell, CD8+ T cells, can become dysfunctional, impeding its ability to seek and kill cancer cells.

More cancer survivors, fewer cancer specialists point to challenge in meeting care needs
An aging population, a growing number of cancer survivors, and a projected shortage of cancer care providers will result in a challenge in delivering the care for cancer survivors in the United States if systemic changes are not made.

New cancer vaccine platform a potential tool for efficacious targeted cancer therapy
Researchers at the University of Helsinki have discovered a solution in the form of a cancer vaccine platform for improving the efficacy of oncolytic viruses used in cancer treatment.

American Cancer Society outlines blueprint for cancer control in the 21st century
The American Cancer Society is outlining its vision for cancer control in the decades ahead in a series of articles that forms the basis of a national cancer control plan.

Read More: Cancer News and Cancer Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.