ASTRO: Standard rad dose outperforms higher dose for lung cancer survival
A higher dose of radiation (74 Gy) does not improve overall survival for non-small cell lung cancer that has spread to the lymph nodes, compared with the standard radiation dose (60 Gy), according to an interim analysis of a randomized study presented at the plenary session on Oct. 3 at the 53rd Annual Meeting of the American Society for Radiation Oncology (ASTRO).
"Most radiation oncologists and lung cancer specialists are surprised by this finding. Although the optimal radiation dose for lung cancer patients has not been tested in a randomized phase III trial for over 30 years, most believed that higher doses of radiation cured more patients with lung cancer," Jeffrey Bradley, MD, a radiation oncologist at the Washington University School of Medicine in St. Louis, said in a statement.
The goal of the phase III trial, according to the abstract, was to compare the overall survival of patients treated with high-dose versus standard-dose radiotherapy with concurrent chemotherapy. They also wanted to test the effectiveness of the chemotherapy drug, Cetuximab.
Investigators randomized 423 patients to different doses of radiation therapy and concurrent chemotherapy of paclitaxel and carboplatin with or without Cetuximab. Patients received one of four treatment arms: standard-dose (60 Gy) versus high-dose (74 Gy) radiation therapy and chemotherapy with or without Cetuximab.
Two types of external beam radiation therapy were used during the trial: 3D conformal radiation therapy (3D-CRT) and intensity modulated radiation therapy (IMRT).
Based on the study's early findings, patients who received the higher dose of radiation (74 Gy) did not have better survival rates than those receiving the standard dose (60 Gy); therefore, the two arms of the trial which used high-dose radiation therapy were closed to patient accrual.
"The trial provides class I evidence that the standard dose of radiation therapy for stage III lung cancer should remain at its existing level of (60 Gy) and doses as high as 74 Gy are not better in curing stage III lung cancer," Bradley said in the statement. "We are not sure why this is the case and our data are still being carefully reviewed."
"Most radiation oncologists and lung cancer specialists are surprised by this finding. Although the optimal radiation dose for lung cancer patients has not been tested in a randomized phase III trial for over 30 years, most believed that higher doses of radiation cured more patients with lung cancer," Jeffrey Bradley, MD, a radiation oncologist at the Washington University School of Medicine in St. Louis, said in a statement.
The goal of the phase III trial, according to the abstract, was to compare the overall survival of patients treated with high-dose versus standard-dose radiotherapy with concurrent chemotherapy. They also wanted to test the effectiveness of the chemotherapy drug, Cetuximab.
Investigators randomized 423 patients to different doses of radiation therapy and concurrent chemotherapy of paclitaxel and carboplatin with or without Cetuximab. Patients received one of four treatment arms: standard-dose (60 Gy) versus high-dose (74 Gy) radiation therapy and chemotherapy with or without Cetuximab.
Two types of external beam radiation therapy were used during the trial: 3D conformal radiation therapy (3D-CRT) and intensity modulated radiation therapy (IMRT).
Based on the study's early findings, patients who received the higher dose of radiation (74 Gy) did not have better survival rates than those receiving the standard dose (60 Gy); therefore, the two arms of the trial which used high-dose radiation therapy were closed to patient accrual.
"The trial provides class I evidence that the standard dose of radiation therapy for stage III lung cancer should remain at its existing level of (60 Gy) and doses as high as 74 Gy are not better in curing stage III lung cancer," Bradley said in the statement. "We are not sure why this is the case and our data are still being carefully reviewed."
Evan Godt, Writer
Evan joined TriMed in 2011, writing primarily for Health Imaging. Prior to diving into medical journalism, Evan worked for the Nine Network of Public Media in St. Louis. He also has worked in public relations and education. Evan studied journalism at the University of Missouri, with an emphasis on broadcast media.