The researchers are now recommending that patients with extensive disease small cell lung cancer are given thoracic radiotherapy (TRT) to treat part of the chest after completing chemotherapy to help extend their lives. The research has been published in the Lancet.
New method to increase chance of survival for some cancer patients
Extensive disease small cell lung cancer (EDSCLC) is either a large volume of disease within the chest or disease that has spread outside the chest. The standard treatment is 4-6 cycles of chemotherapy followed by preventative radiotherapy to the brain (known as prophylactic cranial irradiation or PCI). Very little progress has been made in this disease over the last two decades.
Researchers from Manchester and other UK centres, working with the Dutch Lung Cancer Group in Amsterdam, studied 247 patients aged 35 to 85 who were treated with TRT after chemotherapy and PCI and compared these with 248 patients who received standard chemo and PCI.
The results of the trial, known as REST, found patients who had the additional treatment survived longer and had a better chance of not developing further cancer in the chest.
The TRT treatment did not influence survival rates in the first year but led to a significant increase in survival at two years period – with 13% of patients surviving after TRT compared to 3% of patients in the chemotherapy alone group.
Dr Corinne Faivre-Finn, from The University of Manchester – part of Manchester Cancer Research Centre – the UK Chief Investigator, said: “Our research shows TRT improves both the chance of controlling the disease within the chest and survival and therefore it should be offered to all patients with extensive small cell lung cancer after standard chemotherapy and PCI.”
The research took place between February 2009 and December 2012 and was funded by the Dutch Cancer Society and Cancer Research UK. It was supported by the Dutch Lung Cancer Research Group and The Christie NHS Foundation Trust Clinical Trials Unit.
The paper entitled “Use of thoracic radiotherapy for extensive stage small-cell lung cancer: a phase 3 randomised controlled trial” was published online on September 14. DOI: 10.1016/S0140-6736(14)61085-0
The findings were also presented in Chicago at the 50th Annual Meeting of Science and Society which took place between May 30 and June 3 2014.
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