In a phase III clinical trial, a standard dose of radiation therapy was more effective than a higher dose for the treatment of stage III non-small cell lung cancer (NSCLC). These results will be presented at the 49th Annual Meeting of the American Society of Clinical Oncology.
Radiation therapy plays an important role in the treatment of many patients with NSCLC. Depending on the circumstance, radiation therapy may be used alone or in combination with other types of cancer treatment such as surgery or chemotherapy. Identifying the optimal dose of radiation—one that is highly effective but not too toxic—requires clinical trials that directly compare different doses.
To compare a standard dose of radiation therapy to a higher dose, researchers conducted a phase III clinical trial (RTOG 0617) among 464 patients with stage III NSCLC. The patients were randomly assigned to treatment with either the standard dose of 60 Gy of radiation or a higher dose of 74 Gy. Patients also received chemotherapy with or without Erbitux® (cetuximab). The researchers expected the higher dose of radiation to provide better control of the cancer.
The results indicated that the standard dose of radiation therapy produced longer survival, a lower risk of cancer recurrence, and fewer side effects than the higher dose of radiation therapy.
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- Median overall survival was 28.7 months with the standard dose and 19.5 months with the higher dose.
- After 18 months, a cancer recurrence in the area of the original cancer occurred in 25% of patients treated with the standard dose and 34% of patients treated with the higher dose.
- There were two treatment-related deaths in the standard-dose group and 10 treatment related deaths in the high-dose group.
These results demonstrate that the standard dose of radiation therapy was both more effective and better tolerated than the higher dose. The fact that the less intensive treatment produced better outcomes is good news for patients.
Reference: Bradley JD, Paulus R, Komaki R et al. A randomized phase III comparison of standard-dose (60 Gy) versus high-dose (74 Gy) conformal chemoradiotherapy with or without cetuximab for stage III non-small cell lung cancer: Results on radiation dose in RTOG 0617. Presented at the 49th Annual Meeting of the American Society of Clinical Oncology. May 31-June 4, 2013; Chicago, IL. Abstract 7501.
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