3D Radiation Therapy Increases Lung Cancer Survival

Sophisticated three-dimensional (3D) radiation therapy has been shown to be more effective at curing lung cancer than older two-dimensional (2D) radiation therapy for some patients with early stage lung cancer, according to a new study.

Non-small cell lung cancer (NSCLC) accounts for 87% of all lung cancers diagnosed. At present, the best treatment for stage I NSCLC is surgery or stereotactic radiation therapy (SRT), frequently followed by chemotherapy if the lesion was larger than 3 cm or radiotherapy and chemotherapy if the surgical margin or hilar or mediastinal nodes were positive at the time of operation. The five-year survival rates are very high, with 50-67% of these patients living at least five years after diagnosis if patients had a well-staged stage I NSCLC.

When surgery is not an option because the patient has heart problems or other complications, treatment alternatives include varying types of radiation therapy and chemotherapy, alone or in combination.

In this study, clinicians at the University of Texas M.D. Anderson Cancer Center (Houston, TX, USA) were looking to determine if traditional radiation therapy worked as well as the newer three-dimensional conformal radiation therapy (3D-CRT) at curing patients with early stage non-small cell lung cancer. 3D-CRT was developed to improve upon older types of radiation therapy by allowing clinicians to aim several radiation beams at the tumor to shape or "conform” the radiation to the lung. The strategy of the technology is to customize each beam, allowing doctors to deliver more radiation to the tumor while keeping it away from nearby healthy tissues.

Between 1978 and 2003, 200 patients with medically inoperable stage I NSCLC were treated with radiation therapy alone. Eighty-five received 3D-CRT while 115 received conventional therapy. Thirty-six percent of patients who received 3D-CRT lived five years after diagnosis compared to 10% who received the traditional therapy. Their causes of deaths were more related to intercurrent disease rather than cancer. Local failure was considerably reduced by 3D-CRT compared to conventional radiation therapy.

The findings were published in the September 1, 2006, issue of the International Journal of Radiation Oncology * Biology * Physics.



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M.D. Anderson Cancer Center