Radiation Increases Survival in Certain Lung Cancer Patients

Treating certain lung cancer patients with surgery followed by radiation therapy can improve their chances of long-term survival, according to a study of more than 7,000 patients.

The findings, which suggest the need to reconsider radiation therapy's role in treatment, were published in the June 10, 2006, issue of the Journal of Clinical Oncology.

"Post-operative radiation therapy has failed to demonstrate a survival benefit in the past, likely because previous studies used older equipment,” said Brian Lally, M.D., lead author of the study and a radiation oncologist at Wake Forest University Baptist Medical Center (Winston-Salem, NC, USA). "Our study, which examines the results using modern equipment, shows survival benefit in select patients.”

The study assessed data from the Surveillance, Epidemiology, and End Results Database (SEER), a U.S. national program that gathers information on cancer cases from registries that represent 26% of the U.S. population.

The researchers discovered that in patients whose disease had metastasized to the regional lymph nodes between the lungs, overall survival at five years was 27% in patients receiving surgery plus radiation therapy, compared to 20% in patients who were treated with surgery alone.

In the past, the combination of surgery/radiation therapy was the standard of care for lung cancer. However, this practice changed significantly after an analysis of nine studies revealed that radiation therapy had an unfavorable effect on survival. The aim of Dr. Lally's study was to determine if the advances in radiation therapy technology would result in improved survival. Researchers evaluated results of 7,465 patients who had surgery for lung cancer. About half (47%) received radiation therapy after the surgery and 53% did not.

In all patients, the researchers discovered that radiation treatment did not impact survival. However, when patients were compared based on lymph node involvement, there were distinct differences. In patients where cancer had spread to high-risk regional lymph nodes, survival was improved with radiation therapy.

"For the patients who received surgery and radiation therapy, their survival was better than patients who received surgery alone,” said Dr. Lally. Dr. Lally also reported that researchers need to continue to investigate the improving technology in hopes that all patients can gain benefit. Today, radiation oncologists are utilizing PET-CT (positron emission tomography/computed tomography) and MRI (magnetic resonance imaging) to better visualize tumors and target them with radiation. Intensity-modulated radiation therapy (IMRT), another new technology, is able to regulate the radiation beam to deliver precise doses to specific areas within a tumor.



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