Improving palliative cancer treatment with existing diagnostic scans: Study reveals promising results

A recent study from London Health Sciences Centre and Lawson Health Research Institute suggests that using existing diagnostic CT scans in planning simple palliative radiation treatments can significantly cut down the waiting time for urgent treatment, resulting in a better experience for cancer patients.

“Reducing the time patients spend in a cancer centre has far-reaching benefits,” said lead study author Melissa O’Neil an Advanced Practice Radiation Therapist at London Health Sciences Centre’s (LHSC) London Regional Cancer Program (LRCP). “Faster treatment initiation means quicker relief from symptoms for patients. Utilizing existing scans is also cost-effective and frees up appointment slots or staff, allowing us to accommodate and assist more patients in need.”

Palliative radiation therapy is used to relieve symptoms in patients whose cancers cannot be cured. It’s often used when tumours cause pain, neurological issues or breathing problems such as blocked airways.

In the current standard practice, patients referred for palliative radiation typically require a CT simulation scan before starting their treatment. This scan creates 3D images that the patient's health care team uses to develop a customized radiation treatment plan. Unfortunately, this process often takes several hours, even with efforts to speed it up.

However, many of these patients have undergone previous diagnostic CT scans as part of their routine medical care. Previous research has shown that radiation oncology teams can create suitable palliative treatment plans for patients with bone and soft tissue metastases using these existing scans. This approach is less time-consuming than the more intensive simulation scans.

In the current study, O’Neil and her colleagues explored whether using existing CT scans to plan treatment before a patient arrives at the cancer centre could reduce their wait time while still ensuring appropriate care. They randomly assigned 33 patients who needed palliative radiation for tumours in their chest, abdomen or pelvis to either the standard treatment planning with on-site CT simulation scans or to treatment planning using diagnostic CT scans taken within the previous 28 days.

The study found that patients who didn't need the extra CT simulation scan spent much less time at the cancer centre on the day of their treatment – just under 30 minutes compared to nearly five hours for the others. Treatments were delivered successfully, and patient perception on time spent at the cancer centre was improved for those whose treatment planning used diagnostic CT scans taken without the previous 28 days. 

"For patients who need radiation to help treat symptoms of cancer, it's important for us to get them treated quickly and to minimize the time they spend waiting for medical appointments,” said Dr. David Palma, Radiation Oncologist at LHSC and Associate Scientist at Lawson. “This trial shows that this new approach not only saves resources by reducing the number of scans we do, but also substantially reduces the time patients spend waiting for urgent radiation.” 

"These findings are incredibly promising, especially in light of the nationwide shortage of radiation therapists," said Dr. Michael Ott, Physician Department Executive for Oncology at LHSC. “Work like this has benefits that can reach far beyond London, offering more relief for patients across the country."

The findings were presented at the American Society for Radiation Oncology’s Annual Meeting on Oct. 3, 2023. This meeting is recognized globally as the leading radiation oncology scientific event, drawing more than 8,500 attendees each year. 

While the study shows promise, the research team said it's important to note that using prior diagnostic scans may not be suitable for every type of cancer or patient. It depends on the specific area being treated and the technique used. 

For more information, please contact:    
Jessica Rabaey 
Communications Consultant 
London Health Sciences Centre 
T: 519-685-8500 ext. 77728
Jessica.rabaey@lhsc.on.ca