Intensive therapy gives cancer breakthrough

An advance in the understanding of cancer by doctors has led to the first improvement in survival from one of the worst types of the disease for 20 years.

Researchers found that lung cancer, the commonest cause of cancer death in the Western world, which kills 40,000 people a year in Britain, grows faster than previously thought. Giving radiotherapy three times a day instead of the conventional regime of once a day, increases the rate of survival by 50 per cent.

By giving more frequent doses of radiation, the rapidly proliferating cancer cells are killed and do not have time to regenerate before the next dose. Even a gap of 24 hours is enough to allow the lung cancer to spread. Researchers are testing the technique in other cancers to see if the same applies. Conventional radiotherapy for lung cancer involves 30 treatments given once a day from Monday to Friday over six weeks, with a total dose of 60 Gray (units of radiation).

A trial of the new technique known as Chart - Continuous hyperfractionated accelerated radiotherapy - involved giving 36 treatments three times a day for 12 days, with no breaks at weekends and a total dose of 54 Gray.

The two techniques were compared in 560 patients with non-small-cell lung cancer, the commonest kind, accounting for three-quarters of all cases of lung cancer, over five years.

The results, published in The Lancet, show that 29 per cent of those who had the new treatment survived two years, compared with 20 per cent of those who had the conventional treatment.

Mahesh Parmar, of the Medical Research Council's Cancer Trials Office in Cambridge, which co-ordinated the study, said the technique could have been used decades ago but no one had guessed that the cancer grew so fast. "That is what the results appear to be telling us."

A similar trial of the new technique in head and neck cancers had proved disappointing but it was now being tried in cancer of the oesophagus (gullet), where researchers are more optimistic of securing good results. Studies are also being carried out with chemotherapy to shorten the period over which courses of treatment are given. Of 560 lung-cancer sufferers who started the trial, 444 have died.

Ann Barrett, of the oncology centre at the Western Infirmary, Glasgow, and a member of the research team, said: "Survival is still low. It is not good enough, but it is an improvement. This study has given people hope that it is worth going on trying new techniques even in a disease that is so resistant to treatment."

Lesley Walker, of the Cancer Research Campaign, which part-funded the study, said: "This is the first major improvement in lung cancer survival offered by any form of radiotherapy in the last 20 years."