SAN DIEGO—Stereotactic radiation appears to be highly effective and safe for treatment of patients with operable, early-stage non–small-cell lung cancer (NSCLC). In some cases, it may be an appropriate alternative surgery, resulting in fewer side effects, according to a new Japanese study presented at the 52nd annual meeting of the American Society for Radiation Oncology.
Stereotactic body radiation therapy (SBRT) is an increasingly popular treatment and has been shown to be effective in medically inoperable stage I NSCLC patients. This trial, however, was the first to examine its use in stage I lung cancer patients who are eligible for surgery.
“We can now confirm with more confidence that SBRT is an effective treatment alternative for [older] aged patients with non–small-cell lung cancer,” said Yasushi Nagata, MD, a professor of radiation oncology at Hiroshima University, Japan. “In the future, there is a possibility that radiation will be a substitute for surgery in selected patients with stage I NSCLC. I encourage patients with early lung cancer to talk to their doctor to understand all their treatment options.”
In this study, patients underwent four radiation treatments over the course of 4 to 8 days. SBRT, sometimes called radiosurgery, refers to a single or several highly targeted radiation treatments.
From July 2004 to January 2007, 65 patients from 15 institutions were followed for a median of 45 months posttreatment. Researchers sought to determine the effectiveness and safety of stereotactic radiation treatments by determining the patient group’s overall survival at 3 years after treatment (76%). The mean age of the patients was 79 years (range, 50-91 years), and 45 of 65 patients were men. The median tumor size was 21 mm (range, 10-30 mm).
To date, a total of 25 progressions have been observed, and the 3-year progression free survival rate is 54.5%. The local progression-free survival rate at 3 years is 68.5%, and the event-free survival rate is 51.4%. No grade 4 or 5 toxicities have been observed. Grade 3 adverse events included chest pain in 1.5%, dyspnea in 3.1%, hypoxia in 1.5%, and pneumonitis in 3.1%.
“This would be a lot less painful than surgery,” said Nagata in an interview with The Oncology Nurse. “There is also a big cost savings. The cost could be half of surgery. This is something that American cancer specialists may want to think about. It is important for the oncology nurse to know about this too. This could be a substitute for surgery, and patients need to know this.”
He said this study is particularly important because it included so many older-aged patients. Nagata said that in the United States this approach for these patients is only now starting to become part of clinical practice
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