According to results recently published in journal Chest, radiation therapy improves the average duration survival for patients with early non-small cell lung cancer (NSCLC) who are not able to undergo surgery. The therapy does not, however, provide a cure.

Lung cancer remains the leading cause of cancer-related deaths in the United States. 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. Although radiation therapy is considered standard treatment for these patients, the improved survival gained from radiation compared to supportive care is still being evaluated.

Researchers from New York recently assessed data to compare outcomes of patients with unresectable stages I-III NSCLC. The data included 4,357 patients who were diagnosed between 1988 and 2001. Patients treated with radiation therapy had their average survival times improve by 5 to 7 months compared to those who received no therapy.

Average survival times for patients with stage I NSCLC were 21 months for those who underwent radiation therapy, compared to only 14 months for those who did not undergo treatment. For patients with stage II NSCLC, average survival times were 14 months for those treated with radiation therapy, compared to only 9 months for those who did not undergo treatment. However, at 5 years, survival rates were comparable regardless of treatment with radiation therapy or not: approximately 15% among stage I patients and 10% among stage II patients.

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The researchers concluded that radiation therapy improves the average duration of survival compared to no therapy in patients with unresectable stages I-II NSCLC. However, long-term survival remains poor even for those treated with radiation therapy. Patients with stages I-II unresectable NSCLC may wish to speak with their physician regarding their individual risks and benefits of participating in a clinical trial further evaluating novel therapeutic approaches in order to improve long-term outcomes. Two sources of information regarding ongoing clinical trials include the National Cancer Institute (www.cancer.gov) and www.cancerconsultants.com.

Reference: Wisnivesky J, Bonomi M, Henschke C, et al. Radiation Therapy for the Treatment of Unresected Stage I-II Non-small Cell Lung Cancer. Chest. 2005;128:1461-1467.

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