Lung cancer patients with extenuating health problems may have an alternative to traditional radiation therapy through a lung-sparing procedure pioneered at the Indiana University School of Medicine.
Patients with early stage non-small cell lung cancer responded well to high doses of radiation administered through extracranial stereotactic body radiation therapy, according to an article published in the Nov. 15 issue of the International Journal of Radiation Oncology, Biology and Physics.
The Phase I clinical trial, which looked at the safety and efficacy of the procedure, treated 47 individuals with early-stage cancer who normally would have received surgery and radiation therapy. These patients had extenuating health problems that made them poor candidates for surgery.
"Patients receiving the extracranial stereotactic body radiation were spared the trauma of surgery but were able to undergo higher doses of radiation for a shorter period of time than the standard treatment," said Ronald C. McGarry, M.D., Ph.D., principal investigator of the study and an IU professor of radiation oncology. "I think of the treatment as a lung-sparing approach, and this study shows it is one of the most effective options for lung cancer patients for whom surgery is not an option."
Using precision mapping of the tumor and a sterotactic body frame that keeps the patient virtually immobile, physicians escalated radiation dosages, directing it all to the tumor site and sparing health surrounding tissue. The mapping allows physicians to administer higher doses of radiation while safeguarding uninvolved tissue and organs.
Patients received three treatments in seven to 10 days versus standard therapy of 35 treatments over a six-week period. Physicians treated patients in this study with escalating doses of radiation therapy and were surprised that the careful planning resulted in patients tolerating very intense treatment with few long-term side effects. Only one patient in the higher dose groups had a return of the treated cancer, although 14 of the 47 patients developed spread (metastasis) of their lung cancer.