A new study shows that a new type of targeted radiation therapy called stereotactic radiation therapy is just as good as surgery for patients aged 75 and older with early-stage lung cancer, according to research presented at the 2010 Chicago Multidisciplinary Symposium in Thoracic Oncology. This symposium is sponsored by the American Society for Radiation Oncology (ASTRO), the American Society of Clinical Oncology (ASCO), the International Association for the Study of Lung Cancer (ISLAC) and the University of Chicago.
In this study, researchers compared two treatments for early lung cancer in elderly patients: surgery and stereotactic radiation. Surgery has been the standard treatment for decades, but some oncologists now feel that stereotactic radiation may be as good and are studying it in trials around the world. Stereotactic radiation therapy, sometimes called radiosurgery, refers to a single or several very targeted radiation therapy treatments. Brand names for stereotactic radiation include Axesse, CyberKnife, Gamma Knife, Novalis, Primatom, Synergy, X-Knife, TomoTherapy or Trilogy.
For this trial, researchers looked back at elderly patients with early lung cancer treated in The Netherlands between 2005 and 2007. They found that there were no differences in the long-term survival for patients treated with either treatment but that surgery had a higher risk of death in the first 30 days.
?Many would expect that the patients treated with radiotherapy would do worse than those undergoing surgery,? David Palma, M.D., lead author of the study and a Canadian radiation oncologist who performed the work while on a research fellowship at VU University Medical Center in Amsterdam, Netherlands, said. ?At the time that these patients underwent treatment, patients only received radiation if they were too unwell for surgery or if they refused surgery. Because most radiotherapy patients had medical problems that prevented them from having surgery, we would expect them not to live as long as the surgery patients. Yet, despite this disadvantage, the radiotherapy patients lived just as long. This shows us that the stereotactic treatment is effective even in patients who have many medical problems. I would encourage patients with early lung cancer to talk to their oncologists to learn about all their treatment options, including radiation therapy.?
An unrelated study by the Onishi, Shirato, et al of the School of Medicine, Yamanashi University, Yamanashi, Japan, showed that stereotactic (body) radiation herapy is safe and promising as a radical treatment for operable Stage I NSCLC with a survival rate comparable to that for surgery. Their study was published earlier this year in the International Journal of Radiation Oncology, Biology and Physics.
For more information:
– Palma D, Senan S. Stereotactic radiation therapy: changing treatment paradigms for stage I nonsmall cell lung cancer.Curr Opin Oncol. 2010 Nov 22. [Epub ahead of print]
– Onishi H, Shirato H, Nagata Y, Hiraoka M, Fujino M, Gomi K, et al. Stereotactic Body Radiotherapy (SBRT) for Operable Stage I Non-Small-Cell Lung Cancer: Can SBRT Be Comparable to Surgery? Int J Radiat Oncol Biol Phys. 2010 Jul 15. [Epub ahead of print]