New lung cancer treatment 'biggest advance in 20 years'

CELIA HALL

Medical Editor

A new method of giving radiotherapy to patients with advanced lung cancer has produced the best results for more than 20 years, it was disclosed yesterday.

Interim results of the "Chart" experiments, which involve giving patients radiotherapy continuously, three times a day for 12 days, have increased survival to 60 per cent at one year and 30 per cent at two years. The multi-centre trial was based at Mount Vernon Hospital, Northwood, Middlesex.

The results were revealed to cancer specialists yesterday at the British Oncologic Association meeting in York.

Dr Michele Sanders, who has led the trials with Professor Stanley Dische, director of research and development at Mount Vernon, spoke of "modest" success. But she said: "Such figures are better than most experimental treatments introduced in recent years and have not been exceeded by any group.

"They are the best results we have seen for a long time - 20 years or so. There are cost implications because giving radiotherapy in this way involves radiotherapy departments working in the evenings and at weekends. Obviously, we want to publish our full results and disseminate the information widely. Then it will be for the Government to decide how to proceed," she said.

The trials, which began five years ago, were in two parts: 563 lung cancer patients and 918 patients with cancers of the head and neck have taken part. They received either the best conventional cancer treatment or Continuous Hyper Fractionated Accelerated Radiotherapy (Chart).

The theory is that by giving radiotherapy very frequently over a short period there is less opportunity for the cancer cells inside the tumour to proliferate between treatments. Conventional radiotherapy is usually given over six and a half weeks with patients attending Monday to Friday. It appears that the gaps between treatments allow the cells to multiply, although the tumour size itself may not change significantly.

In the lung cancer trial, patients' disease was too advanced for surgery. With the head and neck cancers, the disease was either too advanced for surgery or surgery would have been distressingly mutilating.

Currently, lung cancer treatments achieve 40 per cent survival at one year and 15 per cent at two years. In the trial the conventionally treated patients achieved 50 per cent at one year and 20 per cent at two years - as often happens to patients in trials - but the Chart patients did even better, 60 per cent were alive at one year and 30 per cent at two years.

In patients with head and neck cancer, those with earlier tumours did equally well. But those with more advanced disease did better on the Chart regime. Those with the most advanced tumours showed 60 per cent clearance compared with 40 per cent clearance with conventional treatment.

There were side effects. With Chart, reactions to radiotherapy appeared sooner and were more troublesome. But they subsided more quickly. The treatment for the short period of time was preferred by the majority of patients even though they had to stay in hospital or in hostel accommodation.

Lung cancer is the commonest cause of cancer death in British men, and an increase in smoking has also dramatically increased death rates among women. Lung cancer kills around 40,000 men and women in Britain a year with 39,000 new cases diagnosed annually. In 1961 male deaths were at a rate of 86.9 per 100,000 of the population and female deaths at a rate of 13.9. By 1991, the male death rate was 91.2 and the female, 42.2.