Palliative Low-Dose Radiotherapy Improves Pain in Hepatic Cancer

TUESDAY, Sept. 10, 2024 (HealthDay News) — For adults with hepatocellular carcinoma or liver metastases, low-dose liver radiotherapy plus best supportive care improve pain compared with best supportive care alone, according to a study published online Sept. 5 in The Lancet Oncology.

Laura A. Dawson, M.D., from the Princess Margaret Cancer Centre at the University of Toronto, and colleagues conducted a randomized controlled phase 3 trial in nine cancer centers in Canada involving adults with hepatocellular carcinoma or liver metastases, who were refractory to standard treatment. After stratification by center and type of cancer, patients were randomly assigned to single-fraction radiotherapy (8 Gy) to the liver with 8 mg ondansetron (or equivalent) orally and 4 mg dexamethasone orally given before radiotherapy plus best supportive care or to best supportive care alone (33 patients were assigned to each group).

The researchers observed an improvement in hepatic pain of at least 2 points in worst pain intensity on the Brief Pain Inventory at one month in 67 percent of 24 patients and 22 percent of 18 patients in the group receiving radiotherapy plus best supportive care and the group receiving best supportive care only, respectively. Within one month after randomization, the most common grade 3 to 4 adverse events were abdominal pain and ascites. There were no serious adverse events or treatment-related deaths reported.

“Given the statistically and clinically significant reduction in pain compared with best supportive care alone at one month, this intervention could become a standard of care treatment for patients with hepatic cancer pain,” the authors write.

Several authors disclosed ties to the pharmaceutical industry.

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