Rethinking Radiation Treatment for acute lymphoblastic leukemia Survivors

A study has shown that survivors of childhood acute lymphoblastic leukemia (ALL) who have not received radiation treatment have similar long-term survival and life experiences as the general population, while those treated with radiation have a slight increase in death rate. The results were reported in the August 14, 2003, issue of The New England Journal of Medicine.

The study included 856 patients treated between 1962 and 1992, of whom 597 were irradiated and 259 were nonirradiated. Among all the patients, four had relapses of cancer. Also, 44 had second tumors, of which 41 were related to radiation therapy, but most were benign growths. Still, people who had received brain radiation as part of their treatment had a slight increase in death rate due to the development of a second cancer. Second tumors continued to develop in patients who received radiation even 20 years after initial treatment, the study showed.

"One of the modifications that we made to our current treatment protocols is to use intensive chemotherapy instead of radiation to control leukemia in the central nervous system,” said lead author Ching-Hon Pui, M.D., director of the leukemia/lymphoma division at St. Jude Children's Research Hospital (Memphis, TN, USA). "This approach appears promising among more than 100 patients treated thus far. Elimination of radiation-related complications can help us to push the cure toward 90% and to improve the quality of life of our survivors.” Currently, the cure rate for ALL at St. Jude is 80%.