First Major Advance in Treatment of Lung Cancer in Years

National Clinical Trial Shows First Major Advance in Treatment of Lung Cancer in Years

A cooperative national clinical trial has produced the first major treatment advance in years for small-cell lung cancer.

The study, which was just published in the New England Journal of Medicine, used two treatments of radiation daily, combined with chemotherapy, compared to the usual practice of delivering one dose a day to the cancer. Specifically, the protocol covered small-cell lung cancer limited to one-half of the chest area.

Cooperating in the trial were the Radiation Therapy Oncology Group (RTOG), the Eastern Cooperative Oncology Group (ECOG) and the Southwest Oncology Group (SWOG).

"Radiation to the chest confined to one lung and adjacent lymphatics improves survival," according to lead author Andrew T. Turrisi, III, M.D. "But there has been lack of agreement on the best ways to integrate thoracic radiotherapy and chemotherapy for this form of lung cancer." Dr. Turrisi is professor and chairman of the Department of Radiation Oncology, Medical University of South Carolina, Charleston.

He explained that the cooperative trial involved 417 patients with limited, small-cell lung cancer. All received the chemotherapy agents cisplatin plus etoposide, while some received radiation once a day and others twice daily. The radiation dose was identical.

The patients who received two radiation treatments daily plus chemotherapy had overall survival rates of 47 percent at two years and 26 percent at five years. Those receiving one radiotherapy treatment daily had rates of 41 percent and 16 percent for the comparable time periods.

The overall survival rates for the two groups of patients was 44 percent for two years and 23 percent for five years, he added. "This represents a considerable improvement in survival rates over previous results in patients with limited, small-cell lung cancer."

RTOG, ECOG and SWOG are federally funded cancer clinical trials cooperative groups that carry out multi-disciplinary research nationwide For further information about RTOG clinical trials, please call Nancy Smith at 215-574-3205.

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