Radiation either before or after chemotherapy and surgery just as effective for treating lung cancer

Radiation therapy before chemotherapy and surgery is just as effective in treating advanced non-small cell lung cancer as chemotherapy followed by surgery then radiation, according to a study presented October 5, 2004 at the American Society for Therapeutic Radiology and Oncology’s 46th Annual Meeting in Atlanta.

Advanced non-small cell lung cancer continues to be a difficult disease for doctors to treat effectively. In this study, researchers sought to evaluate whether it was more effective to treat patients with radiation and chemotherapy before surgery or whether chemotherapy followed by surgery and then radiation was better.

In one of the largest patient population studies in Europe, researchers worked with the German Lung Cancer Cooperative Group to enroll 558 patients with stage IIIA and IIIB lung cancer from 29 cancer centers in a randomized trial. Each of the patients first received three cycles of induction chemotherapy before being treated with either pre-operative radiation therapy followed by surgery or surgery followed by radiation therapy.

The overall result of the treatments were good, with a three-year survival rate of 26.2 percent for those in the pre-operative group and 24.6 percent for patients in the post-operative group. There was no difference found between the two treatments regarding tumor control. The study also showed that toxicity concerns remain with both treatments. Patients in the pre-operative group had a higher incidence of grade III esophagitis whereas the post-operative patients showed a higher incidence of grade III/IV pneumonitis.

“The results of this trial show that neither of the treatment regiments have a clear advantage over the other,” said Christian Ruebe, M.D., lead author of the study and a radiation oncologist in the Department of Radiotherapy at Saarland University in Hamburg, Germany.

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