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UK-US study compares radiotherapy with proton therapy in childhood cancer

The Royal Marsden NHS Foundation Trust and The Institute of Cancer Research, London, are leading a collaborative international study looking at the potential benefits of proton radiotherapy for young patients with brain tumours. 

With the Massachusetts General Hospital in Boston, USA, clinicians at Europe’s leading cancer centre are aiming to compare the use of proton therapy in the treatment of the paediatric brain tumour, medulloblastoma, with conventional photon radiotherapy. 

The study will be looking at the quality of life of patients who have survived medulloblastoma who have been treated at The Royal Marsden with state of the art photon therapy, including intensity modulated radiotherapy, which was pioneered by The Royal Marsden and its research partner, The Institute of Cancer Research. Their outcomes will be compared with those from patients who have been treated for the same condition with proton therapy at Massachusetts General Hospital. 

Dr Henry Mandeville, Consultant Clinical Oncologist at The Royal Marsden Hospital, and lead investigator for the study in the UK, said: “This study is an important step to improving paediatric cancer treatment and survival. It will both inform the debate on proton radiotherapy and clarify its role in the management of paediatric cancers. 

“In this era of escalating healthcare costs and budgetary constraints, it is essential that the value of new medical technologies be measured and proven by comparing the health outcomes between old and new technologies.” 

Professor Louis Chesler, Team Leader in Paediatric Therapeutics at the ICR and Honorary Consultant at The Royal Marsden, said: “Proton radiotherapy is an important new technology with potential benefits – especially for difficult-to-treat cancers such as central nervous system tumours and medulloblastoma. This small study could be important in helping to support future clinical trials that use this technology in medulloblastoma. 

“The clinical evidence on proton radiotherapy is unclear, and we need to gather important data through this kind of study to justify cost-benefit decisions on when to use it. More formal studies and clinical trials must be done to clarify when this technology should be used.” 

Patients with standard-risk medulloblastoma have a good prognosis with approximately 80% surviving long term. Currently, 22 patients from The Royal Marsden have been recruited for the study, from a broad range of socio-economic backgrounds. 

As part of the study, patients will be asked to fill out a quality of life questionnaire. 

The study has received £65,000 in funding from the Cancer Recovery Foundation UK and its US-based sister charity, the Children’s Cancer Recovery Foundation. At The Royal Marsden the money will fund a Clinical Nurse Specialist for one day a week to help deliver the questionnaire and collate the data. 

Recent research, including a 2012 report published by the American Society of Clinical Oncology, has shown that cancer survival rates for children have increased to around 80%. However, treatment can sometimes leave children with side effects that can affect their quality of life. 

Patrick Tonks, CEO of the Cancer Recovery Foundation UK charity, said: “We hope that this will be the start of a long and fruitful relationship with The Royal Marsden and that their cancer patients will also be able to benefit from the wide-ranging support that the Cancer Recovery Foundation UK can provide.” 

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