New radiotherapy technique can reduce swallowing issues and improve quality of life for head and neck cancer patients

by Gazette Reporter
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A new precision radiotherapy technique has proven highly effective in addressing swallowing issues for head and neck cancer patients, according to newly published results from a clinical trial.

The results of a multi-centre study across Ireland and the UK focusing on patients primarily diagnosed with HPV-positive oropharyngeal or throat cancers, demonstrated significant improvements in swallowing function, known as dysphagia. Traditionally, intensity-modulated radiotherapy (IMRT) has been the standard treatment for head and neck cancer, but it can potentially harm vital organs like the swallowing muscles, leading to significant side effects. To address this concern, researchers developed DO-IMRT, a novel technique that minimises radiation to the muscles involved in swallowing. Comparing DO-IMRT to standard IMRT, the trial showed patients experienced fewer side effects and improved swallow within just 12 months.

Funded by Cancer Research UK and sponsored by Cancer Trials Ireland, the study included 118 patients across 22 radiotherapy centres in Ireland and the UK. Published in The Lancet Oncology, the results demonstrated that the Dysphagia-optimised IMRT (DO-IMRT) group showed significantly better scores in aspects related to swallowing function compared to the standard IMRT group. Notably, 62% of DO-IMRT patients reported normalcy of diet and were able to eat in public, while only 45% of standard IMRT patients achieved the same scores. The study’s outcomes reinforce the benefits of DO-IMRT in improving swallowing performance, as reported by both patients and speech and language therapists.

Professor Sinead Brennan, the Irish Principal Investigator, a consultant radiation oncologist at St. James’s Hospital and St. Luke’s Radiation Oncology Network and Chair of the Head and Neck Cancer group at Cancer Trials Ireland, emphasised the meaningful difference this trial could make for patients’ quality of life, stating, “Eating and drinking play a central role in our lives, especially during special occasions spent with loved ones. The ability to relish these moments and share meals with family and friends has a profound impact on our overall quality of life.

Prof. Brennan continued, “Over 40% of cancer cures can be attributed to radiotherapy, yet it often takes a backseat to chemotherapy in public awareness. For half of all cancer patients, radiotherapy is a crucial and life changing option. The findings hold the promise of advancing the DO-IMRT technique, which could lead to additional benefits for patients through the use of cutting-edge methods such as proton beam therapy, or adaptive radiotherapy.

“One of the most difficult side effects we see with patients with head and neck cancers following radiation treatment is the impact it can have on swallow function. Being part of this clinical trial and observing the positive differences in reducing problems with swallowing and eating for our patients is an important step in improving the outcomes for them, and all the head and neck cancer patients we treat”, Prof. Brennan concluded.

500 people develop head and neck cancers every year in Ireland with half of these patients being treated at the Trinity St James’s Cancer Institute. A multidisciplinary team cares for these patients, including speech and language therapists. 

Professor Maeve Lowery, Co-Director of the Trinity St. James’s Cancer Institute, praised the collaborative spirit evident in this research and emphasised the significance of ongoing efforts in this field, stating, “This trial exemplifies the exceptional research capabilities in Ireland and the benefits to Irish patients of taking part in international clinical trials.”

“Our goal is to ensure every patient, regardless of their circumstance, can partake in clinical trials. This research serves as a prime example of our commitment to enhancing cancer treatments for patients across Ireland”, Professor Lowery concluded.

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