A novel radiotherapy approach has shown promise as a treatment option, and may possibly increase the cure rate, for people with early stage lung cancer who are unable to tolerate surgery, according to findings from a five-year study led by SUNY Upstate Medical University.
SUNY Upstate was among 10 institutions nationwide participating in this first prospective radiotherapy study specific to high-risk patients with early stage lung cancer. The findings were presented at the American Society of Clinical Oncology meeting June 4 in Chicago.
“Although the majority of patients with stage 1 non-small cell lung cancer (NSCLC) may be cured following surgery to remove a whole section of the lung, a substantial portion of these patients have poor lung function or other medical problems, making them unsuitable for major surgery,” said the study's principal investigator, Jeffrey A. Bogart, M.D., professor and chair of the Department of Radiation Oncology at SUNY Upstate Medical University. “We need to find a safe and effective way to treat this patient population.”
Bogart noted that an earlier study tested an approach of limited surgery on these patients, removing the tumor with only a small portion of the diseased lung. However, while findings from this study indicated that limited surgery may be effective in certain patients, the role of limited surgical resection in the high-risk population remained unclear. This led investigators to test a new theory that would involve treating the tumor solely with dose-intensive accelerated three-dimensional conformal radiotherapy.
“Our primary objectives were to determine the maximally accelerated course of conformal radiotherapy for high-risk stage 1 NSCLC and to describe the short- and long-term toxic effects of conformal radiotherapy in this population,” said Bogart. “We also wanted to assess the efficacy of such a technique.”
Conformal radiotherapy uses advanced technology to precisely target the tumor and the surrounding normal structures in 3 dimensions using CT or MRI scans, and then sculpt the radiation dose to the shape of the tumor. “We are better able to conform the radiation dose to the exact location of the tumor, avoiding critical structures and providing more intense therapy directly to the tumor,” said Bogart.