Findings by scientists at The Christie NHS Foundation Trust in Manchester, which were presented at a leading European radiation oncology conference, could help extend the lives of lung cancer patients in the future.
Around 56% of lung cancer patients develop severe lymphopenia (reduction of the count of white blood cells) during radiotherapy treatment. This can cause infection that reduces the chances of survival. Based on this study, survival for lung cancer patients without lymphopenia averages 21 months but for those that develop lymphopenia this tends to reduce to an average of 15 months.
The Christie research team applied a new approach to identify regions of the body that must be spared during radiotherapy to avoid severe lymphopenia after treatment. Archive scans taken from 562 lung cancer patients treated with radiotherapy at The Christie were studied, and the findings were validated in a cohort of patients with cancer of the oesophagus. It was shown that the heart and spine should be avoided as much as possible. However this is not always possible if the tumour is close to these organs.
Following the findings, researchers suggested personalising treatments to improve the outcome by reducing the radiation dose to these organs affecting for immune system, and if that is not possible, frequently monitoring the blood counts during therapy and prescribing antibiotics are recommended.
Honorary scientist at The Christie, Dr. Azadeh Abravan added: “Radiotherapy side-effects can have a significant negative impact on a patient’s survival. For the first time, we performed a comprehensive study showing which organs are responsible for treatment related lymphopenia. This side-effect can be reduced by limiting radiation to these organs. Also, novel types of radiotherapy including the more precise proton therapy will help reduce this important side-effect in the future”.
Prof. Corinne Faive-Finn, clinical oncologist specialising in lung cancer at The Christie said: “We know lymphopenia can occur after radiotherapy but the areas of the chest that should be avoided are not well known. Now we understand which organs contribute to lymphopenia after radiotherapy, we can improve our treatments and patient’s outcome. Patients who develop lymphopenia tend to have a survival time that is six months less compared to other patients, although we need to understand better the reasons for this.”
The NIHR Manchester Clinical Research Facility at The Christie is a large, high quality, dedicated clinical research environment where our patients can participate in complex and early phase clinical trials. Around 650 clinical trials may be taking place at any one time.
The Christie NHS Foundation Trust has been ranked ‘Outstanding’ by the health regulator the Care Quality Commission (CQC) which referred to it as ‘exceptional’ and ‘a leader in its field’. It not only commended the Trust for its effectiveness and care, but highlighted its work in shaping the future of cancer care and noted the reach and influence of its clinical research projects. The CQC also rated The Christie the best specialist trust in the country, and one of the top three trusts overall in England.