A single dose of radiotherapy is as “effective” as five doses for end-of-life cancer patients suffering with painful spinal canal compression, finds a large study conducted by UCL, including The University of Manchester.
Spinal canal compression is a common complication in cancer patients when the cancer has spread to their spine. Radiotherapy is used to control pain and alleviate symptoms. Around three to five in 100 people (3-5%) with cancer develop spinal canal compression, which equates to around 4,000 people in the UK each year.
As part of the SCORAD randomised clinical trial, published in JAMA, researchers wanted to find out if giving just one dose (single-fraction) of radiotherapy could be used instead of five doses (multi-fraction) which requires several hospital visits.
The lead trial investigator, Professor Peter Hoskin (University of Manchester, Mount Vernon Cancer Centre (NHS)), said: “In the UK, NICE guidelines do not currently stipulate a standard treatment regimen, though most patients with spinal canal compression or other metastatic bone disease are given several fractions.
“We believe our findings, which show equal clinical effectiveness for single-dose radiotherapy, provide strong evidence for NICE guidelines, and those in other countries, to be changed to stipulate a one-dose one-visit approach, reducing unnecessary discomfort for end of life cancer patients without compromising efficacy.”
Co-author Professor Allan Hackshaw (CRUK & UCL Cancer Trials Centre, UCL Cancer Institute) said: “Terminally ill cancer patients with spinal canal compression suffer significant problems such as being unable to walk, and pain. Radiotherapy is an effective treatment for these patients.
“At the moment, with no recommended radiotherapy schedule for these patients, many are given several doses of radiation treatment, and each dose requires a separate visit to the hospital. Patients and their carers have to make multiple journeys, which can be uncomfortable to patients, inconvenient and expensive.
