Radiation Can Help When Liver Cancer Is Inoperable

NEW YORK (Reuters Health) - Adding high-dose radiation therapy to local chemotherapy improves the survival of patients with liver cancers that can't be removed surgically, according to a new report. "I would like physicians to be aware of the potential usefulness of high-dose ... radiotherapy for those patients who do not have surgical options," Dr. Edgar Ben-Josef from the University of Michigan, Ann Arbor, told Reuters Health. "There is currently little awareness of radiotherapy as an option for these patients." As reported in the Journal of Clinical Oncology, Dr. Ben-Josef and colleagues treated 128 patients with inoperable liver cancer with high-dose radiation therapy and infusion of the chemo agent floxuridine into an artery supplying the liver.

The overall survival rate at three years was 17 percent, the team reports, and the average survival was 15.8 months after the start of radiotherapy. That compares with the 8-to-9 months average survival expected in these circumstances.

Nearly half the patients with primary liver cancer were free from disease progression at 3 years, the report indicates, whereas only 15 percent of the patients whose liver cancer arose from the spread (metastasis) of colorectal cancer achieved the same milestone. "I'd like to emphasize that this is not an alternative to chemotherapy in those who are candidates for chemotherapy." Dr. Ben-Josef explained. "There is no reason why patients could not have both, and we believe that these two forms of therapy are complementary in metastatic colorectal cancer: aggressive systemic therapy plus aggressive local therapy." His team is about to begin a trial of "intensity-modulated radiotherapy with concurrent floxuridine," Dr. Ben-Josef added. "Our preliminary work has suggested that we can deliver an even higher dose than we had in the reported trial with the same or reduced expected level of toxicity." SOURCE: Journal of Clinical Oncology, December 1, 2005.