An advanced linear accelerator for cancer treatment
An advanced linear accelerator for cancer treatment iStock

Sheba Medical Center, Israel’s largest medical center and a Newsweek top-10 ranked world’s best hospital for the last four years, announced Tuesday the results of an international study examining the use of a novel celiac plexus radiosurgery treatment for pain management in advanced cancer patients.

The study will be presented by lead author Dr. Yaacov Richard Lawrence at the 2022 American Society for Radiation Oncology (ASTRO) Annual Meeting in San Antonio this week (abstract LBA-06, 52325).

A common symptom of pancreatic cancer is severe pain in the abdomen or midback, which worsens with time and is often challenging to treat. The pain is thought to be caused by the tumor pressing onto and infiltrating the celiac plexus nerve network that lies immediately behind the pancreas. Dr. Lawrence, Director of the Center for Translational Radiation Oncology at Sheba Medical Center, and his team hypothesized that targeting the celiac plexus with radiation would reduce pain, and after a positive pilot study, embarked on a four-year validation study of 125 patients.

“Pancreatic cancer pain can be debilitating for patients, and few options are currently available for alleviating it,” said Dr. Lawrence. “The positive results of this study are encouraging, and we believe celiac plexus radiosurgery should become a standard treatment option for pain relief for patients in their advanced stages of pancreatic cancer and other cancers invading the celiac plexus nerve.”

Patients’ pain interference scale scores, which measure how much the pain interferes with their everyday lives, improved significantly both three and six weeks after receiving a single radiation treatment. Of the 90 evaluable patients at three weeks after initial treatment, 48 (53.3 percent) had at least a partial pain response, with the average pain score dropping 2.5 points at three weeks and 3.2 points at six weeks. The treatment was well-tolerated by study participants, whose median age was 65.5, and no severe side effects were reported.

This trial establishes celiac plexus radiosurgery as a viable treatment option for patients with pancreatic tumors or other tumors invading the celiac axis, lessening the use of opioids and analgesics for pain treatment.

In addition to the central study center at Sheba Medical Center, research was conducted in other leading institutions in the United States, Canada, Poland, and Portugal, including: Icahn School of Medicine at Mount Sinai, Sidney Kimmel Cancer Center at Thomas Jefferson University, Princess Margaret Cancer Centre at the University of Toronto, Ohio State University Wexner Medical Center, Tel-Aviv Sourasky Medical Center, Assuta Medical Center, Maria Sklodowska-Curie National Research Institute of Oncology of Poland, and the Portuguese Oncology Institute of Porto.

The celiac plexus radiosurgery study was funded by the Gateway for Cancer Research, a nonprofit dedicated to funding transformational cancer research, with additional funding from the Israel Cancer Association.