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For Release: October 23, 2000
Concurrent Chemotherapy and Radiation Therapy Increases Survival of Patients with Locally Advanced Non-Small Cell Lung Cancer
Patients with locally advanced non-small cell lung cancer live longer if they are treated with radiation therapy and chemotherapy at the same time rather than by chemotherapy first followed by radiation therapy, a new study shows.
The study of 592 patients found a 17.1 month median survival rate for patients treated concurrently, which was significantly better compared to 14.6 months for those treated sequentially, says Ritsuko Komaki, M.D., of MD Anderson Cancer Center in Houston, TX. Patients who were treated with chemotherapy followed by twice-a-day radiation had a median survival rate of 16 months.
This study consisted of three different treatment arms: patients in arm 1 were treated with chemotherapy first followed by daily radiation therapy; patients in arm 2 were treated with concurrent chemotherapy and daily radiation therapy, and patients in arm 3 of the study were treated with concurrent chemotherapy and twice daily radiation therapy, says Dr. Komaki.
It's interesting to note that when chemotherapy and twice-a-day radiation therapy were given at the same time, there was better control of the tumor within the treated area compared to patients who were treated by chemotherapy followed by radiation therapy, says Dr. Komaki. Those with non-squamous cell cancer were more likely to have brain and other distant metastasis, she says. This indicates that these patients need more aggressive chemotherapy and possible prophylactic brain irradiation, she adds.
Twice daily radiation therapy caused higher incidence of acute esophagitis -- difficulty in swallowing which led to weight loss or dehydration with occasional hospitalization compared to once daily radiation therapy given concurrently with chemotherapy, says Dr. Komaki. There was no significant difference in the late toxicities between the three different treatment arms, she says. "We are hopeful that by using new techniques, such as 3D conformal radiation therapy, which allow us to target the radiation more precisely, we will be able to reduce the toxicity levels," she says.
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