Less invasive early-stage lung cancer treatment as effective as surgery and radiation, AGH study finds

PITTSBURGH/Miami – A newer, non-surgical way of treating high-risk, early-stage lung cancer patients with stereotactic radiation is as effective as limited surgery and brachytherapy (radioactive seed implantation), providing patients with another  good treatment alternative,  according to a study by Allegheny General Hospital radiation oncologists.

The study is being presented today at the annual meeting of the American Society for Therapeutic Radiology and Oncology (ASTRO) in Miami Beach, Fla., and is one of several being presented by AGH researchers. Founded in 1958, ASTRO is the largest radiation oncology society in the world with more than 10,000 members committed to advancing the scientific base of radiation therapy and extending the benefits of radiation therapy to patients with cancer and other diseases.
“We now have multiple options for these high-risk patients with early-stage lung cancer, where before they had limited options ,” said lead researcher Athanasios Colonias, MD. “These are two viable therapeutic regimens  and choosing between them may simply come down to patient preference.”

This study is one of the biggest thus far to compare the two methods, and a much larger, randomized study is soon to be underway through the American College of Surgeons Oncology Group (ACOSOG). Allegheny General will participate in the ACOSOG study.

The AGH researchers studied 213 patients with Stage 1 non-small-cell lung cancer from January 1996 to January 2011. The patients were considered high-risk because their lung function was compromised or they suffered from other lung or heart diseases and could not tolerate the standard surgical procedure of lobectomy. The patients ranged in age from 50 to 91.

Of the patients enrolled, 145 were treated with surgery and brachytherapy. An additional 68 patients were treated with stereotactic body radiotherapy, which uses a very high dose of radiation delivered very precisely to the lung tumors. It is an outpatient procedure, and painless.
Patients in the study who underwent surgery stayed in the hospital an average of six days, and peri-operative mortality rate was 3.4 percent. The stereotactic group had no treatment-related deaths.

The overall 1 and 2-year survival for the surgery/brachytherapy group was 85 percent and 71 percent, while overall 1 and 2-year survival rates for the stereotactic radiation group were 84 percent and 66 percent.

“The stereotactic technique is non-surgical and has limited side effects. Opting for surgery, however, may offer an advantage to doctors in terms of getting a better view of the tumor and providing more accurate staging, which is not as easily done with the non-surgical procedure,” said Dr. Colonias.
“Close collaboration between the surgical oncologist and radiation oncologist can help us determine which approach is best based on the individual patient circumstance,” Dr. Colonias added.

Also involved in the study were David Parda, MD, Chair, Department of Radiation Oncology, West Penn Allegheny Health System; Olivier Gayou, Ph.D, DABR, System Director, Physics Research and Development Department of Radiation Oncology, Allegheny General Hospital; E. Day Werts, Ph.D., System Director of Education and Clinical Research; Katherine Kotinsley, MD, Chief Resident, Radiation Oncology Residency, AGH; Benjamin Kotinsley, MD, Radiology Resident, AGH; James Betler, DO, Radiation Oncologist, AGH, and Fiore Alite, fourth-year medical student

For more information, contact: