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Quality of life study shows radiation can improve pain management for liver cancer patients

An understudied type of cancer receives new attention, with the potential to treat tumours that have spread to other parts of the body

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KINGSTON, ON – January 20, 2023 –  Late breaking results shared today at the ASCO Gastrointestinal Cancer Symposium for the Canadian Cancer Trials Group (CCTG) HE1 phase III study of palliative radiation therapy for symptomatic hepatocellular carcinoma and liver metastases.

This Canadian study investigated whether one dose of palliative radiation therapy directed to the liver in combination with the standard, best supportive care could help to reduce pain and discomfort for patients with end-stage primary or metastatic liver cancer. This patient population are often not a good fit for standard therapies, and experience pain that cannot be controlled well with pain medication alone. The goal of a palliative radiation intervention is to improve pain management and quality of life.

“This study found that one treatment of simple radiation therapy delivered to the liver resulted in clinically important and statistically significant reduction in patient reported pain one month following treatment,” says Dr Laura Dawson, the HE1 study chair and a Radiation Oncologist at Princess Margaret Hospital, UHN. “The majority of patients treated experienced reduced pain that allowed them to enjoy more quality time near the end of their life.”

Sometimes radiation therapy is given in the “palliative” setting to treat discomfort and not necessarily to shrink or eliminate a tumour. Palliative radiation therapy is often given when patients have painful bone tumours but has not been widely used to address liver cancer pain. The study concludes that for these patients, low dose radiation should be considered a standard palliative intervention. It is a simple treatment not reliant on any specific radiation technology, and an option for any center with a radiation treatment unit — potentially improving the quality of life for patients with hepatic cancer pain globally.

A family member of a study participant stated, “I believe in my heart that the radiation treatment given to (my husband) … gave him at least another 6 weeks of a good quality of life that he might not otherwise have had.”

The trial was funded in part with a grant from the Canadian Cancer Society (CCS) to accelerate and focus the knowledge gained from scientific findings into outcomes resulting in the reduced burden or enhanced quality of life for people with cancer.

“CCS is proud to support CCTG and to continue funding scientifically excellent research that places people at its core,” says Dr Stuart Edmonds, Executive Vice-President of Mission, Research and Advocacy at CCS. “We are grateful to our donors who played a role in supporting this impactful clinical trial that has potential to benefit not just people with cancer in Canada but around the world.”

HE1 results

This multicenter Canadian phase III randomized controlled trial in patients with locally advanced, end-stage, painful primary or metastatic liver cancer (59% with an ECOG performance status of 2 or 3, 26% with impaired liver function, Child-Pugh B or C), found that a single fraction of low dose radiation therapy to the liver led to a significant and clinically important improvement in pain at 4 weeks, compared to best supportive care alone. Using the brief pain inventory, patient reported pain at worst (in the past 24 hours) was improved by 2 points or more on a scale from 0-10 in 67% of patients receiving radiation therapy, compared to 22% receiving best supportive care alone (p=0.004). There was a trend for improved 3-month survival with radiation therapy (51% versus 33% for best supportive care alone, p=0.07).

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Media Contact

Lisa Callahan | 343-363-7158 | lcallahan@ctg.queensu.ca

About the Canadian Cancer Trials Group

The Canadian Cancer Trials Group (CCTG) is a cancer clinical trials research cooperative that runs phase I-III trials to test anti-cancer and supportive therapies in over 80 institutions across Canada and internationally. We are supported by core funding from the Canadian Cancer Society. From our centre at Queen’s University in Kingston, Ontario, we have supported over 500 trials in over 40 countries aimed at improving survival and quality of life for all people with cancer.

About the Canadian Cancer Society

The Canadian Cancer Society works tirelessly to save and improve lives. We fund the brightest minds in cancer research. We provide a compassionate support system for all those affected by cancer, across Canada and for all types of cancer. As the voice for people who care about cancer, we work with governments to shape a healthier society. No other organization does all that we do to make lives better today and transform the future of cancer forever.

Help us make a difference. Call 1-888-939-3333 or visit cancer.ca today.

La Société canadienne du cancer travaille sans relâche afin de sauver et d’améliorer des vies. Nous finançons les plus brillants chercheurs sur le cancer. Nous fournissons un réseau d’aide empreint de compassion à toutes les personnes atteintes de cancer, dans tout le Canada et pour tous les types de cancer. En tant que voix des personnes qui ont le cancer à cœur, nous travaillons de concert avec les gouvernements pour créer une société en meilleure santé. Aucun autre organisme ne fait ce que nous faisons pour faire en sorte d’améliorer des vies aujourd’hui et de transformer l’avenir du cancer à jamais.

Ensemble, agissons contre le cancer. Appelez-nous au 1 888 939-3333 ou visitez cancer.ca aujourd’hui.