Adding Radiation to Chemotherapy May Dramatically Improve Survival for Advanced-Stage NSCLC Patients

According to a new clinical trial reported at the 59th Annual Meeting of the American Society for Radiation Oncology (ASTRO), combining radiation therapy with chemotherapy for patients with limited metastatic non-small cell lung cancer (NSCLC) may curb disease progression dramatically when compared to NSCLC patients who only receive chemotherapy.

Lung cancer claims the most cancer-specific deaths of any tumor type.  Few existing treatments offer durable survival benefits for patients whose NSCLC has spread past the lungs, due in part to the aggressive nature of lung cancer and its propensity to progress, even following treatment.  Research on metastatic colorectal cancer and sarcoma, however, suggests a potential benefit from adding local therapy, treatment directed specifically at the tumor cells, to the standard approach of systemic therapy.  In these studies, adding radiation or/and surgery bolstered the ability of systemic therapies, such as chemotherapy, to control disease and improve survival in patients with few metastases.

The study was a randomized phase II trial testing whether the addition of local treatment, in the form of consolidative radiation therapy, to the standard treatment of systemic therapy improved progression-free survival for patients with limited metastatic NSCLC.  Eligible patients included those with stage IV disease, spread to six or fewer sites including the primary tumor site, and who responded at least partially to first-line/induction chemotherapy.

Patients were randomly assigned to receive either maintenance chemotherapy alone or a combination of stereotactic ablative radiotherapy (SAbR), also known as stereotactic body radiation therapy or SBRT, to all sites of disease followed by maintenance chemotherapy.  Radiation to metastases was offered as a single fraction, three fractions, or five fractions of SAbR and radiation to the primary disease site was delivered through 15 fractions of hypofractionated radiation therapy if the primary tumor was too central or involved mediastinal nodes.  Maintenance chemotherapy was left to the discretion of the treating medical oncologists.

Results of the trial showed progression-free survival in the trial escalated from 3.5 months to 9.7 months with the addition of radiation therapy delivered to all the metastatic sites of lung cancer as well as the primary disease site and treatment-related side effects were similar for the two treatment approaches.

At Illinois CyberKnife, lung cancer patients are treated with SBRT using the CyberKnife® Robotic Radiosurgery System.  CyberKnife is a painless, nonsurgical outpatient cancer treatment with minimal to no side effects.  During the CyberKnife treatment, hundreds of highly concentrated and incredibly precise beams of radiation are targeted directly to tumors and lesions in the lung.  As the patient breathes during the CyberKnife treatment, the CyberKnife robotic arm moves with the rise and fall of his/her body, meaning that healthy tissue is protected from radiation and only the tumor is treated.

For more information about how Illinois CyberKnife treats lung cancer with CyberKnife technology, please click here today.