Zapping Better Than Cutting

Lung cancer patients with severe COPD live longer with radiotherapy

(RxWiki News) Chronic obstructive pulmonary disease (COPD) is commonly seen with lung cancer, because both diseases usually result from smoking. Patients who have COPD often have complications after lung cancer surgery.

Research suggests there's a better way to treat these individuals.

A new study has demonstrated that stereotactic body radiotherapy (SBRT) is better than surgery for extending the lives of lung cancer patients who have severe COPD

"If you are experiencing shortness of breath, see a doctor."

A research team led by David Palma, M.D., M.Sc., a radiation oncologist at the London Regional Cancer Program in London, Ontario, Canada, analyzed how patients fared after surgery or SBRT.

Surgically removing non-small-cell lung cancer tumors is the standard treatment for patients with early stages of the disease. Having COPD increases the likelihood of complications following surgery.

For patients who aren't good candidates for surgery, SBRT - a newer radiation treatment -has been proven to be effective for people with Stage I lung cancer.

For this study, researchers looked at patients with Stage I lung cancer who had severe COPD. They found:

  • One year following radiotherapy, 79-95 percent of patients were still alive vs. 45-86 percent of those who had been treated with surgery alone
  • At three years, 43-70 percent of SBRT patients were living compared to 31-66 percent of patients who had had surgery.

"SBRT is a safe and effective less-invasive option for lung cancer patients with COPD that does not have the added risks of surgery-related mortality and prolonged hospitalization," Dr. Palma said.

He concludes that all early stage lung cancer patients should be "evaluated in a multidisciplinary setting and afforded an informed decision of the risks and benefits of both surgery and SBRT."

"The data are very encouraging and the approach with stereotactic radiation for this type of tumor, and particularly in patients who are not fit for surgery makes a lot of sense, Fred R. Hirsch, M.D., Ph.D., professor of medicine and pathology at the University of Colorado Cancer Center, told dailyRx.

"However, the approach is relevant also for surgically fit patients and results from ongoing and future prospective randomized studies will direct clinical practice," said Dr. Hirsch, who was not involved in the study.

This research appears in the March, 2012 issue of the International Journal of Radiation, Oncology, Biology, Physics, the official scientific journal of the American Society for Radiation Oncology (ASTRO).