Using radiation as a secondary treatment to prevent cancer progression

This trial treated patients with advanced non-small-cell lung cancer with consolidative radiation therapy after chemotherapy. The authors concluded that this treatment plan has potential to improve progression free survival and overall survival in these patients.  

Initial treatment with chemotherapy can cause cancer to disappear to an undetectable level, however, some cancerous cells can remain. Consolidative therapy involves treating these patients with further therapy to kill any more cancer cells. Stereotactic body radiotherapy involves delivering high dose radiation to targeted sites in the body and is therefore commonly used as consolidative therapy.  

Studies looking at metastatic (spread) non-small-cell lung cancer (NSCLC) showed that cancer is likely to reoccur at the known site of disease. It is possible then that treating patients with consolidative radiation therapy (CRT) after initial chemotherapy would be beneficial.  

This trial treated patients with advanced NSCLC with CRT following successful treatment with chemotherapy. Patients included had less than 5 tumors across 3 or less sites in the body, aside from the original lung tumor site. 27 patients were treated with CRT 28 days after receiving their last dose of chemotherapy. 

The patients underwent follow-ups every 3 months. The average total follow-up was 24.2 months.  

Side effects from CRT were uncommon, however 1 patient had a grade 2 rib fracture due to treatment.  

Average progression free survival (PFS, time from beginning trial until disease progression) was 11.2 months. Average overall survival (OS, time from beginning trial until death) was 28.4 months. 

The site of the metastatic tumors made no difference to PFS and OS.  

The authors concluded that using CRT after chemotherapy to treat patients with advanced NSCLC could be beneficial at improving PFS and OS.  

Further larger, randomized trials are needed to confirm these results.