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Precision radiotherapy delivers survival gains in inoperable lung cancer

12/02/2019

A new clinical trial by TROG Cancer Research has shown for the first time that a new radiotherapy technique produced greater survival rates in early stage inoperable lung cancer patients, compared to conventional radiation treatment. The TROG 09.02 CHISEL study aimed to investigate if Stereotactic Ablative Body Radiotherapy (SABR) is more effective than standard radiotherapy for patients with non-small cell lung cancer (early stage lung cancer).

SABR is a new, highly-targeted technique for delivering very high radiotherapy doses targeted at a patient’s tumour. The high doses ensure patients complete their treatment sooner than for conventional radiotherapy, as the required dose can be given over fewer trips to hospital.

The CHISEL study was a Phase III clinical trial involving 101 patients with inoperable early-stage Non-Small Cell Lung Cancer, from Australia and New Zealand, and who were randomised to receive either SABR or conventional radiotherapy.

Professor David Ball, who headed the trial, said the results were practice-changing. “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. 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.”

After two years, 77% of the patients who received SABR treatment were surviving compared to 59% of those who received conventional radiotherapy. Conventional radiotherapy for this cancer requires the patient to return to hospital regularly over six or seven weeks to receive their required radiation dose in small amounts. With SABR, the same 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.

“As the SABR technique is much more precise, only the cancer is treated and the surrounding healthy tissue is unaffected,” Professor 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, which began in 2010, is the first to demonstrate a survival benefit from SABR in non-small cell lung cancer.

Maureen Chrul, was one of the patients who signed up to participate in the CHISEL trial. The 76 year old received the new SABR technique to treat her lung cancer. Maureen has also experienced conventional radiation therapy for an earlier cancer treatment.

“I didn’t have any side effects with the SABR technique and I had just three treatments, which was much better than the six weeks of radiation treatment I had to treat another lung tumour. With the traditional treatment I felt much more tired with that treatment and had some burning to by chest and back,” said Maureen.

This trial was a collaboration involving TROG Cancer Research and the Australasian Lung Cancer Trials Group (ALTG). The trial was funded with grants from Cancer Australia, The Cancer Society of New Zealand and the Cancer Research Trust New Zealand.

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