Historically, patients with locally advanced Stage IIIA or B non small cell lung cancer were treated with radiation therapy resulting in 5-year survival rates of only 3-10%. This clinical trial sponsored by the National Cancer Institute was conducted to determine whether the combination of Platinol® (cisplatin) and Velban® (vinblastine) chemotherapy followed by radiation therapy could improve the patient’s chance of survival compared to the traditional treatment of radiation therapy alone. In this clinical trial, 78 patients were randomly assigned to receive chemotherapy and radiation therapy and 77 patients received radiation therapy alone. The 2 therapies were then directly compared for potential side effects and overall survival benefit.
Both treatment strategies were very well tolerated with the major side effects encountered by patients consisting of nausea and vomiting, neutropenia, and anemia. The direct comparison of patients receiving sequential chemotherapy and radiation therapy to patients receiving radiation therapy alone demonstrated that patients receiving the sequential chemotherapy-radiotherapy were twice as likely at 2 years and almost 3 times as likely at 5 years to be alive compared to patients receiving radiation therapy alone.
In summary, this clinical trial demonstrated that combined modality therapy with Platinol® based chemotherapy followed by radiation was superior to radiation therapy alone for the treatment of Stage IIIA-B non small cell lung cancer and should now be considered a standard treatment approach. Future treatment strategies to improve upon these results will focus on incorporating new chemotherapy agents, sequences of administering therapy, or whether chemotherapy, radiation therapy, and surgery could be superior to chemotherapy and radiation therapy alone. (Journal of National Cancer Institute, Vol 88, pp 1210-1215, 1996)
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