Accelerated Radiotherapy Brings Survival Benefit

June 2010, Vol 1, No 2 - 2nd European Lung Cancer Conference

Geneva—Giving lung cancer patients radiotherapy more frequently and over a shorter period of time provides an overall survival benefit, according to the results of a meta-analysis presented at the 2nd European Lung Cancer Conference. These positive results were found for both non-small-cell lung cancer (NSCLC) and small-cell lung cancer, although the study was not sufficiently powered to detect a statistically significant difference between the standard and modified radiotherapy regimen for smallcell lung cancer.

The meta-analysis was conducted by Cecile Le Pechoux, MD, and colleagues from Institut Gustave-Roussy in Villejuif, France, and analyzed 2279 patients with nonmetastatic lung cancer from 10 trials. They found that in the 8 trials dealing with NSCLC, modified fractionation of the radiotherapy improved overall survival compared to conventional radiotherapy, resulting in an absolute benefit of 3% after 5 years (ie, 3% more of the patients were alive after 5 years) in the modified fractionation groups.

“The clinical benefit we found was small, but comparable to the benefit found in other meta-analyses concerning non–small-cell lung cancer,” Dr Le Pechoux said.

The standard treatment for lung cancer patients is combined radiochemotherapy, but the benefit of accelerated radiotherapy regimens has been unclear, as different randomized trials have given contradictory results.

In discussing earlier work in this area in the press release announcing her findings, Dr Le Pechoux commented that “the most recent metaanalysis evaluating the best way to combine radiotherapy and chemotherapy in NSCLC…showed that concomitant chemoradiation (with a 5-year survival rate of 15.1%) is superior to sequential chemoradiation (5-year survival rate of 10.6%) and the best results shown in randomized trials in small-cell lung cancer–limited disease show 5-year survival rates of 20% to 25%. Thus there is need for improvements of both radiotherapy and chemotherapy.”