Studies show frequent dose radiotherapy boosts survival

GENEVA – (Cancer Digest) – A new analysis of data pooled from multiple studies reported at the second European Lung Cancer Conference shows that patients with both non-small-cell lung cancer and small-cell lung cancer benefit in terms of overall survival when treated with hyperfractionated or accelerated radiotherapy.

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 In the study presented today Cecile Le Pechoux and colleagues from Institut Gustave Roussy in Villejuif, France analyzed 10 trials including 2,279 patients with non-metastatic lung cancer. They found that patients treated with hyperfractionated or accelerated radiotherapy regimens are given their treatments more frequently, and over a shorter period of time had a small survival advantage over those treated with current treatment schedules. The benefit of the more frequent schedule has been in question as different randomized trials have given contradictory results.

In the most recent meta-analysis evaluating the best way to combine radiotherapy and chemotherapy in NSCLC, the results showed that giving chemotherapy and radiation at the same time produced a 5-year survival rate of 15.1%, which is superior to giving chemotherapy followed by radiation therapy, which produced a 5-year survival rate of 10.6%. In addition, the best results shown in randomized trials in small-cell lung cancer limited disease show 5-year survival rates of 20-25%. Thus there is need for improvements of both radiotherapy and chemotherapy, Pechoux said.

In their study, Pechoux and colleagues found that in the eight trials dealing with non-small-cell lung cancer, modified fractionation of the radiotherapy improved overall survival compared to conventional radiotherapy, resulting in an absolute benefit of 3 percent after 5 years, meaning that 3 percent 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," Le Pechoux said.

In small-cell lung cancer, which is a less common form of the disease, similar results were found, although the difference in survival between the standard and modified radiotherapy regimens was not statistically significant because there were not enough patients to analyze.
These results could encourage further work to determine how best to deliver radiotherapy for lung cancer patients, Pechoux said.

"Interest in modified fractionation was uncertain before the meta-analysis, but the current results will lead to renewed interested in this research field," he said.