According to a recent article published in the Journal of Clinical Oncology, treatment with chemotherapy plus radiation therapy is promising in patients with early-stage non-small cell lung cancer (NSCLC) who are not able to have their cancer surgically removed.

Lung cancer remains the leading cause of cancer-related deaths in the US. Non-small cell lung cancer is the most common type of lung cancer, accounting for approximately 75-80% of all lung cancers. It is named for the type of cell within the lung from which the cancer originated.

Stages I-II NSCLC refers to cancer that has not spread from the lung and may be cured with surgery with or without chemotherapy and/or radiation therapy. Unfortunately, some patients with this disease are not considered candidates for surgery (unresectable), either due to the anatomical location of the cancer or the patient’s overall health. Some patients also refuse treatment with surgery due to associated side effects and healing time.

Radiation therapy alone may improve survival in these patients compared to supportive care alone. Continuing research evaluates the potential of combining radiation with various chemotherapy regimens to improve survival in this group of patients.

Researchers from Yugoslavia recently conducted a clinical trial to evaluate the effectiveness of radiation therapy plus the chemotherapy agents Paraplatin® (carboplatin) and Taxol® (paclitaxel) in the treatment of patients with stages I-II NSCLC. This trial included 56 patients; 72% refused surgery, 21% had other existing medical conditions, and 7% were deemed too old for surgery.

This treatment appeared promising, particularly for those without other existing medical conditions. The following results were recorded at a follow-up of approximately 20 months:

  • 1-year survival of entire group was 82%; 5-year survival was 36%.
  • 1-year survival of patients less than 60 years of age was 85%; 5-year survival was 42%.
  • 1-year survival of patients older than 60 years of age was 78%; 5-year survival was 26%.
  • 1-year survival of patients with other significant medical issues was 25%; none of these patients survived 5 years.
  • 1-year survival of patients who refused surgery was 98%; 5-year survival was 50%.

The researchers concluded that chemotherapy plus radiation therapy may provide comparable results to surgery in patients with stages I-II NSCLC. The results were much greater in patients who refused surgery compared to those with other significant medical conditions. Patients with stages I-II NSCLC who are not eligible to undergo surgery, or do not wish to undergo surgery, may wish to speak with their physician regarding their individual risks and benefits of treatment with radiation plus chemotherapy.

Reference: Jeremic B, Milicic B, Acimovic L, et al. Concurrent hyperfractionated radiotherapy and low-dose daily carboplatin/paclitaxel in patients with early-stage (I/II) non-small cell lung cancer: long term results of a phase II study. Journal of Clinical Oncology. 2005;23:6873-6880.

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