Researchers have developed radiation therapy for a specific nerve, which significantly improved patients' quality of life and greatly reduced their pain levels. The study was published in the prestigious international journal Lancet OncologyA new Israeli study conducted at Sheba Medical Center has been published in the prestigious international journal Lancet Oncology - the world's leading cancer journal. The study was led by Dr. Yaacov Lawrence, Director of the Radiation Oncology Institute at the Hussmann Comprehensive Cancer Center at Sheba, and focuses on a new treatment method for pain relief in pancreatic cancer patients using focused radiation. The international study was made possible thanks to support from the American research body Gateway for Cancer Research and the Israel Cancer Association.
Severe pain is one of the characteristics of pancreatic cancer because the pancreas is located very close to a central nerve called the celiac plexus, and pancreatic tumors tend to press on or invade this nerve, causing very severe pain. This pain causes great suffering to patients and affects their functioning and quality of life.
Until now, the accepted treatments for this pain were through pain medications or, in severe cases where the pain is resistant to drugs, an invasive treatment - injection of anesthetics directly into the celiac plexus nerve and its deactivation (Celiac Block).
Dr. Lawrence's study actually examined a different treatment method - a one-time radiation using X-rays directly to the nerve (and not to the tumor). This treatment method was developed at Sheba's Radiation Institute by Dr. Lawrence, the institute's chief physicist Dr. Maoz Ben-Ayun, and Prof. Zvi Symon. The method was first examined in a relatively small study conducted at Sheba about six years ago. The study examined the effect of a single radiation treatment at a relatively high radiation dose to the nerve. Following the promising results of the initial study, Dr. Lawrence and his colleagues received a grant to conduct a large international clinical trial. The study, led by Sheba researchers, began about five years ago and was conducted in 8 hospitals from five countries: USA, Canada, Poland, Portugal, and Israel. In Israel, the study was conducted in three medical centers: Sheba is the global primary medical center in the study, and in two secondary centers: Assuta Ramat Hahayal and Ichilov.
Dr. Yaacov Lawrence, Director of the Radiation Institute at Sheba and who headed the study, explains: "As doctors, we treat the person first, not just the disease. The issue of pain originating from the celiac plexus nerve is one of the things that causes the most suffering to pancreatic cancer patients. These are severe pains that greatly disturb patients and affect their daily functioning and quality of life. In cases where the pain intensifies and causes patients to need high doses of morphine-family drugs that have severe side effects, the solution until now was an invasive procedure that deactivates the nerve by deep injection.
We had an innovative idea to try a different therapeutic approach - to use external radiation focused on the nerve itself, not on the tumor in a non-invasive way."
The international study involved 125 patients who received a single high-dose radiation treatment to the celiac plexus nerve. 53% of them reported a significant decrease in pain as a result of the treatment and a noticeable improvement in their quality of life. The side effects of the treatment, as revealed by the study, are few and not severe (mainly fatigue and mild nausea on the day of treatment).
Moshe Bar Haim, CEO of the Israel Cancer Association, added that "we hope that the new study will allow immediate implementation in Israel and worldwide to alleviate the suffering of pancreatic cancer patients and possibly other types of cancer as well. It's important to emphasize that thanks to public donations and designated funds, the Association's research committee annually provides funding to Israeli researchers and doctors. Research has no territorial boundaries, so any achievement here in Israel is an achievement for the whole world. Because from these studies, new methods for diagnosing and treating cancer patients have been developed."
The study achieved another important milestone - the treatment method examined in it has been included in the American guidelines for pancreatic cancer treatment by the National Comprehensive Cancer Network (NCCN). This means that it is a treatment recommendation taken into account throughout the Western world and is available to most patients in the US. At Sheba, the treatment has been available and performed on patients for several years.
"The publication of the article in a leading journal is a great honor for Israeli medicine in general and Sheba in particular, and is further evidence of the quality of cancer research and treatments in Israel," shares Dr. Lawrence. "I thank our partners within Sheba who contributed to making it a quality study at an international level and the international and local bodies that supported us. And of course, a big thank you to the patients who volunteered to participate in the study and their families."
The study had partners at Sheba including Prof. Talia Golan who established the Pancreatic Cancer Center at Sheba and greatly assisted in recruiting patients for the study, Dr. Maoz Ben-Ayun, chief physicist and deputy director of the Radiation Institute, who planned the treatments and instructed other physicists around the world on how to perform the treatment, Prof. Zvi Symon, former director of the Radiation Institute who supported the project throughout, Prof. Dror Harats, head of the Research Authority at Sheba, who managed the international study at the administrative level, the Israeli Association for Cardiovascular Trials (ICCR) under the management of Prof. Robert Klempfner, who logistically managed the data in the study, Dr. David Hausner, director of the Supportive Care Unit at Sheba Medical Center who designed the original study, and Prof. Laurence Freedman and Dr. Ronen Fluss from the Gertner Institute who managed the biostatistical aspect of the study.