Is chemo-radiotherapy beneficial?

This study evaluated the safety and efficacy of chemotherapy (CT) given concurrently with 3-dimensional conformal radiotherapy (3D-CRT) for the treatment of patients with metastatic non-small cell lung cancer or mNSCLC (lung cancer that has spread to distant organs of the body). 

Chemotherapy (CT) uses drugs that kill rapidly growing cancer cells. CT with platinum-based drugs, is the most preferred method of treatment for mNSCLC. 3D-CRT is a widely used method of radiation therapy that uses several high-energy radiation beams to damage and kill cancer cells. This method ensures that the irradiated area fits as exactly as possible to the shape of the tumor. This allows a higher amount of radiation to be targeted at the tumor, while reducing the toxicity to surrounding tissues. CT can be used alone or in combination with 3D-CRT, a method referred to as chemo-radiotherapy. However, the role of chemo-radiotherapy for mNSCLC patients has not been well determined.

A total of 201 with mNSCLC patients were involved in this study. All patients were treated with chemotherapy and 3D-CRT at different dosages. Results showed that, for patients who received a 3D-CRT dose of 63 Gy or more, the median survival time (MST) was 14.0 months, while the 1, 2 and 3 years overall survival or OS (the percentage of patients who survive a certain time after the treatment) was 58.7%, 22.0% and 16.3%, respectively. For patients who received a radiation dose of less than 63 Gy, MST was 8.0 months and OS rates for 1, 2 and 3 years were 24.2%, 11.4% and 3.8%, respectively. Patients who received more than 4 cycles of CT had a MST of 14.0 months as compared to 8.0 months in those who received less than 4 cycles. 

Moreover, 3D-CRT dosages influenced the outcome of CT. Patients who received more than 4 cycles of CT with additional higher than 63 Gy 3D-CRT had an MST of 16 months, whereas those who received less than 63 Gy 3D-CRT had an MST of 8 months. However, no differences were observed when CT doses varied on radiotherapy dosage outcome. Side effects were mostly gastrointestinal and were manageable.

In summary, the study showed that high doses of 3D-CRT following more CT cycles improved OS in the treatment of mNSCLC patients, with manageable toxicity. 

Talk to your doctor about the most appropriate therapy in your situation.