Precision radiotherapy effective in inoperable lung cancer

A newly developed and highly precise radiotherapy technique has been shown to produce greater survival rates in patients with inoperable non-small cell lung cancer (NSCLC) compared to conventional radiotherapy.

Stereotactic ablative body radiotherapy (SABR) is a highly targeted technique for delivering very high radiotherapy doses targeted at a patient’s tumour. Unlike conventional radiotherapy, which requires NSCLC patients to return to hospital regularly over six or seven weeks to receive their required radiation dose in small amounts, treatment is delivered in a more concentrated dose — and in a highly targeted way — requiring only three to four visits to hospital over around two weeks.

The technique was trialled in the head-to-head CHISEL study, a Phase III clinical trial involving 101 Australian and New Zealand patients with inoperable early-stage NSCLC who were randomised to receive either SABR or conventional radiotherapy. The trial was led by the Peter MacCallum Cancer Centre (Peter Mac) and run by TROG Cancer Research since its inception in 2010, with the results now finally published in The Lancet Oncology.

“Our trial found that for patients with early-stage lung cancer, SABR was more effective in controlling cancer growth, resulting in longer life expectancy, and is just as safe as traditional radiotherapy,” said Professor David Ball, Peter Mac’s Director of Lung Cancer Service, who headed the trial.

“We found that 89% of cancers were controlled two years after SABR treatment and this compared to 65% for conventional radiotherapy, and there was also a clear benefit in overall survival,” Prof Ball continued. 77% of the patients who received SABR treatment were surviving after two years, compared to 59% of those who received conventional radiotherapy.

“As the SABR technique is much more precise, only the cancer is treated and the surrounding healthy tissue is unaffected,” Prof Ball said.

“Not only is the treatment more effective, but it is more convenient with fewer hospital attendances, which is a significant bonus.”

The trial is said to be the first to demonstrate a survival benefit from SABR in non-small cell lung cancer.

Image caption: Professor David Ball explains to patient Maureen Chrul how the Linac machine delivers SABR.

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