Re-irradiation for lung cancer has the potential for long-term control of lung cancer in some patients but is underused due to the risk of serious side effects including damage to healthy lung tissue. However, there have been significant advances in radiotherapy technology and techniques over the past decade which may allow sparing of normal lung tissue and the safe delivery of re-irradiation. This new treatment could help approximately 700 lung cancer patients in the UK each year.
This is a complex treatment with no published guidelines on how to select patients and to deliver this treatment safely. As part of his Beatson Cancer Charity funded PhD research project, Dr Rulach and his colleagues undertook a large survey on the international practice of re-irradiation for non-small cell lung cancer.
The objective of this project was to develop recommendations in this under-researched field. Dr Rulach and his colleagues recruited 15 radiation oncology experts (with an interest in re-irradiation) from across the globe to participate in the development of consensus statements. This involved a series of surveys on the practice of re-irradiation for lung cancer and the development of practical guidelines. Dr Rulach and his colleagues completed a consensus paper with practical guidelines which was accepted for publication by the Advances in Radiation Oncology Journal in January 2021. You can read the full paper here.
This paper is the first published set of practical guidelines about re-irradiation for lung cancer. The paper describes suitable patients for re-irradiation, areas of uncertainty, and critically patients who are unlikely to benefit from the treatment. Furthermore, the paper suggests dose limits and radiotherapy technique.
Beatson Cancer Charity provided a grant of £1,570 for changing the status of the paper to an open-access paper which will enable researchers, clinicians and students around the world to view and download the full paper for free. The paper will help to improve the safety of re-irradiation by standardising this treatment for lung cancer.
Applications of the paper
Using the available information from the publisher, the paper has been recognised on Twitter and retweeted over 40 times, placing it in the top 10% of social media mentions for the journal in the last 3 years. The information from the practical guidelines has already been applied in the following situations:
The practical guidelines have also been used to adjust re-irradiation treatments for eligible patients which has resulted in tumour reduction and improvements in symptoms.