“A retrospective analysis published this week confirmed that childhood cancer survivors are living longer and experiencing fewer secondary malignancies while they are still young (i.e., within 15 years of their original diagnosis). Drawing on data from the annual Childhood Cancer Survivor Study, researchers linked this decline with, among other factors, drops in both the number of pediatric patients treated with radiation therapy and the average radiation dose administered to these patients.
“The study makes clear the progress that radiation oncologists and collaborative oncology teams have made in reducing the side effects associated with cancer treatment, including secondary cancers. Indeed, the lead study author noted the findings demonstrate that ‘efforts to reduce the late effects of treatment are paying off.’
“This payoff reflects, in part, better decision-making by oncology teams about which patients are appropriate for various treatments, including radiation. As the study notes, oncologists know more than ever and learn more every day about which childhood cancers will respond best to radiation.
“The drop in secondary malignancies, however, also underscores dramatic improvements in our ability to deliver radiation in a way that reduces long-term side effects. Advances in radiation oncology that occurred during this study's timeframe of the 1970s through 1990s are contributing to increased survival, fewer side effects and improved outcomes. We know that these improvements have only accelerated since 1999, when the last patients in this report were treated. Innovations such as proton therapy and advanced imaging, for example, allow us to better target and reduce overall radiation dose, maximizing our ability to eliminate cancer without compromising functional outcomes.
“As the study authors state, radiation continues to be an ‘important component’ for treating many childhood cancers. While we work to reduce late effects, we must remember that cure rates drop and failure rates rise when radiation is removed from the equation. (See here and here and here.) For these young patients, we need to continue delivering curative therapy while we find new and innovative ways to reduce the side effects of treatment.
“Particularly with younger patients, the risk of a secondary cancer is a real possibility that must be weighed along with the benefit and side effects of initial treatment. Radiation oncologists are constantly working to achieve the difficult and delicate balance between curing the cancer and reducing late effects, including secondary malignancies.
“We encourage parents and caregivers to remember that radiation therapy remains part of the solution to many childhood cancers. This study shows that we're beating back childhood cancer because of sophisticated treatments like radiation therapy, not in spite of them.
“We also encourage parents to talk with their oncology team members, including a radiation oncologist, who will be most knowledgeable about the risks and benefits of radiation therapy. This dialogue can ensure that all cancer treatment options are considered and that treatment decisions are driven by the best available evidence.
“ASTRO will continue educating radiation oncologists and the oncology community on the appropriate use of radiation therapy, including with pediatric patients. We also support greater investments in innovative combined modality treatments and research to radically accelerate progress against childhood cancer. By working together, we can achieve what all oncologists aim to do—cure as many patients as possible, as safely as possible.”