Improving pain relief for patients with advanced cancers

A trans-national clinical trial, involving Peter Mac patients, has found stereotactic ablative body radiation therapy (SABR) provides superior relief from painful spinal lesions than standard radiation therapy.

The SC24 phase II/III trial – which involved patients in Canada and Australia – showed SABR was effective both for more patients, and for longer, at relieving the pain caused by secondary tumours in the spine.

Pain is a quality of life issue

Associate Professor Shankar Siva said the findings were practice-changing and would lead to improved quality of life for many patients with advanced cancers in need of pain relief.

“We know that up to 40% of patients with solid cancers will develop secondaries in the spine – across many different types of cancer – and back pain is a major issue for quality of life,” said Associate Professor Siva, who led the trial in Australia in behalf of the Trans Tasman Radiation Oncology Group (TROG Cancer Research).

“Conventional radiation therapy for pain relief is the current standard-of-care. This trial has shown that SABR – as an advanced form of this treatment – leads to even better pain relief which is more durable than standard radiation therapy.”

A more precise and targeted option

SABR is more precise and targeted than standard radiation therapy, and involves delivering higher doses of radiation across fewer treatment sessions.

After three months, 35% of participants randomised to the trial’s SABR arm reported no remaining pain from their treated spinal lesions, compared to 14% who received standard radiation therapy. After six months, 32% in the SABR arm reported no pain compared to 16%.

The trial was coordinated by the Canadian Cancer Trials Group at Queen’s University in collaboration with the Study Chair, Dr Arjun Sahgal, Cancer Ablation Program Director at Sunnybrook Health Sciences Centre in Toronto. Associate Professor Siva was awarded a National Health and Medical Research Council (NHMRC) grant to conduct the study across Australia through TROG Cancer Research, with Peter Mac as the lead site.

The trial results are published in the journal Lancet Oncology.