Not all Cancer Therapies Help

Lung cancer patients do not always live longer with post surgical radiotherapy

(RxWiki News) Determining the best treatment plan for lung cancer is based on a number of factors. New research suggests one form of therapy that doesn't extend life may be overused with older patients.

Older patients with advanced lung cancer should not be routinely given radiation therapy following surgery, because it doesn't help them live longer, according to a recently published study.

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Juan Wisnivesky, M.D,, Dr.PH, of the Mount Sinai School of Medicine, and his colleagues reviewed and analyzed information from the Surveillance, Epidemiology and End Results (SEER)-Medicare registry. This database links cancer incidence and survival data to a master file of Medicare records.

Researchers found and identified 1,307 people who had locally advanced lung cancer between 1992 and 2005. Locally advanced cancer has spread only to nearby lymph nodes, but not to other organs.

Of all these individuals, 710 people (54 percent) received radiation therapy after surgery, but they were not more likely to live longer than patients who did not receive radiation.

"Our results show that we need more information about the potential benefits of radiation therapy before it is used routinely to treat this subset of lung cancer patients," said Dr. Wisnivesky.

dailyRx Contributing Expert, Fred R. Hirsch, M.D., Ph.D., put this into perspective. "Approximately 30 percent of lung cancer patients in stage I and up to 60 percent of patients with pathological stage II experience disease relapse and/or die from their lung cancer despite surgical removal of the primary tumor. Therefore, additional therapies to the surgery are explored," explained Dr. Hirsch, who is professor of medicine and pathology at the University of Colorado Cancer Center.

Dr. Hirsch, who was not involved in the current research, says that this study was a retrospective [looks back] study and "cannot generate more than a hypothesis, which needs to be confirmed or denied in a prospective [observes outcomes] study." 

This type of study is under way, Dr. Hirsch points out.  "Such a prospective is currently ongoing (The Lung Adjuvant Radiotherapy Trial), and data from such a trial is needed to answer the question whether additional radiotherapy after surgery gives a benefit or not, not only in elderly patients but in other age groups as well."

Dr. Hirsch concludes, "Hopefully, one day we will come to the stage that we know how to select lung cancer patients for radiotherapy in the same way as we today do for some “specific targeted therapies” for patients with advanced stage of lung cancer, which has for subgroups of lung cancer patients resulted in significant response and outcome to treatments."

This research was published early online in CANCER, a peer-reviewed journal of the American Cancer Society.

The study was funded by the National Institutes of Health. No author reported any conflicting financial relationships.