Early Lung Cancer Therapy Increases Survival

Two large studies show that in some cases of early-stage non-small cell lung cancer, treatment with chemotherapy after surgery improves overall survival significantly, compared to surgery alone.

These results help to solve the controversy over whether or not patients with early-stage non-small cell lung cancer should have chemotherapy following surgery. Earlier trials have had contradictory results or shown a small benefit.

In the first trial, 344 patients with stage 1B tumors that had been completely removed were randomized to receive either no chemotherapy after surgery or chemotherapy with paclitaxel and carboplatin. After four years, 71% of the patients receiving chemotherapy after surgery were alive compared to 59% who had surgery alone. The risk of death from lung cancer specifically was reduced by 49%. The study was halted early when it became clear that the chemotherapy group had significantly better survival. This study was led by Gary M. Strauss, M.D., of Rhode Island Hospital, Brown Medical School (USA).

In the second trial, 482 patients with stage IB or stage II tumors that had been removed by surgery were divided into two groups: one received no chemotherapy after surgery while the other group received cisplatin and vinorelbine. This study was led by Timothy Winton, M.D. for the Clinical Trials Group of the National Cancer Institute of Canada (Toronto). Overall survival was 94 months for the chemotherapy group and 73 months for those in the other group. The results were published in the June 23, 2005, issue of The New England Journal of Medicine.

There were no treatment-related deaths in the first trial but two in the second trial. The side effects of chemotherapy were well tolerated, with the most severe side effect being neutropenia in the first trial, and neutropenia, hearing loss, numbness, and parathesias in the second trial.





Related Links:
Brown Medical School
National Cancer Institute of Canada