The results of a recently reported clinical study at the 56th Annual Meeting of the American Society for Radiation Oncology (ASTRO) in San Francisco demonstrate that thoracic radiation improves survival and reduces cancer recurrence when added to prophylactic cranial irradiation in patients with extended-stage small cell lung cancer.(1)
Small-cell lung cancer (SCLC) is a fast-growing type of lung cancer and accounts for approximately 25%-30% of all lung cancers. A common site spread, or metastasis, of SCLC is the brain. Once brain metastases have been detected, radiation directed to the sites of cancer is a common treatment.
The multinational CREST trial enrolled 498 patients with extended-stage small cell lung cancer who had a complete, partial, or good response to initial platinum/etoposide chemotherapy. Patients were assigned to receive treatment with prophylactic cranial irradiation with or without thoracic radiotherapy and their outcomes directly compared.
At 24 months, survival was 13% in the group treated with thoracic radiotherapy vs only 3% for prophylactic cranial irradiation alone. Progression-free survival was also significantly longer in the group receiving thoracic radiotherapy, with a 27% reduced risk of recurrence compared with prophylactic cranial irradiation alone.
The study authors concluded that “thoracic radiation should be added to prophylactic cranial irradiation and be offered to all extended-stage small cell lung cancer patients with a response to initial chemotherapy to improve outcomes.”
1.Slotman B, Faivre-Finn C, van Tinteren H, et al: ASTRO Annual Meeting. Abstract CT-05. Presented Sept 14, 2014.
2.Slotman BJ, van Tinteren H, Praag JO, et al: Lancet. Sept 12, 2014 (early release online).