In a nutshell
This trial compared the survival of lung cancer patients, between patients receiving standard radiation therapy and those receiving radiation therapy given on alternative schedules (hyperfractionated or accelerated).
This research was prompted by recent findings that suggest a benefit with hyperfractionated or accelerated radiation therapy over conventional radiation therapy for some cancers patients.
Hyperfractionated radiation therapy means that the doses of radiation are given in smaller quantities, but with 2-3 sessions per day instead of one. Accelerated radiation therapy means that the total dose of radiation is given in sessions spaced closer together, delivering a higher amount of radiation in a shorter overall treatment time.
Methods & findings
For non-small cell lung cancer (NSCLC) patients, this analysis was performed using data combined from 10 previous trials including a total of 2000 patients. Some of the patients received standard radiation therapy, while others received hyperfractionated or accelerated radiation therapy. 5 years after treatment, the overall survival rates were 10.8% for patients who had received hyperfractionated or accelerated radiation therapy, compared to 8.3% for patients treated with standard radiation therapy.
For small cell lung cancer (SCLC) patients, this analysis was performed using data combined from 2 trials including a total of 685 patients with limited disease (one that has not yet spread to the opposite lung). Overall survival 5 years after treatment was improved in patients treated with hyperfractionated or accelerated radiation therapy. The 5-year survival rate was 23.8% for patients treated with hyperfractionated or accelerated radiotherapy, compared to 18.7% for patients treated with standard radiation therapy. However, this difference in the survival of SCLC patients was not considered statistically significant (results showed a high variability and considered not reliable).
In both NSCLC and SCLC patients, alternative radiation therapy regimens were associated with a higher risk of developing esophagitis (inflammation of the esophagus, which connects the mouth to the stomach).
The bottom line
Hyperfractionated or accelerated radiation therapy improved survival compared to standard radiation therapy in both NSCLC and SCLC. However, the benefit was statistically significant only for NSCLC patients.
The fine print
This study was performed based on data obtained from previously published trials. Since their publication, several improvements in radiotherapy techniques have been recorded. A new analysis, preferably a direct comparison between two groups of patients followed-up for a long time period, would help confirm these results.
Consult with your physician regarding the various radiation therapy strategies available for the treatment of lung cancer.
Published By :
Journal of clinical oncology
Aug 01, 2012