According to an article recently published in the Journal of Clinical Oncology, early radiation therapy to the thorax may not improve survival when used in combination with chemotherapy for the treatment of limited small-cell lung cancer. However, because results from this trial are not consistent with other findings, further study is needed to determine the true clinical impact of radiation therapy timing.

Small cell lung cancer (SCLC) is an aggressive form of lung cancer. Limited SCLC refers to early lung cancer that has not spread to distant sites in the body. Standard therapy for limited-stage SCLC often includes surgery (if possible) chemotherapy, and/or radiation therapy. However, optimal timing of radiation to the thorax has remained unclear.

Researchers from England recently conducted a clinical trial to evaluate the timing of radiation therapy in the treatment of SCLC. This trial included 325 patients with limited SCLC who had not received prior therapies. Participants were treated with combination chemotherapy plus radiation therapy. Approximately half of the patients were treated with early radiation therapy (during the second cycle of chemotherapy), and approximately half received late radiation therapy (during the sixth cycle of chemotherapy).

  • 69% of patients treated with early radiation therapy were able to complete all six cycles of chemotherapy, compared with 80% of patients treated with late radiation therapy.
  • There was no significant difference in survival times between the two groups of patients (survival for both was between 14 and 15 months).

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The researchers concluded that results from this particular clinical trial did not demonstrate an improved outcome in limited SCLC with the use of early radiation therapy compared to later administration of radiation therapy. However, the authors stated that “the results of a meta-analysis suggest that it is essential to ensure that the delivery of chemotherapy is optimal when administered with early TRT” (thoracic radiation therapy).

Patients diagnosed with limited stage SCLC may wish to speak with their physician regarding the optimal timing of radiation therapy for their individual case.

Reference: Spiro S, James L, Rudd R, et al. Early Compared With Late Radiotherapy in Combined Modality Treatment for Limited Disease Small-Cell Lung Cancer: A London Lung Cancer Group MulticenterRandomized Clinical Trial and Meta-Analysis. Journal of Clinical Oncology. 2006; 24:3823-3830.

Related News:Long-Term Lung Function Maintained Following Chemotherapy and Radiation Therapy in SCLC (3/17/2006)

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