Study: Chest Radiation Helps Small Cell Lung Cancer Patients Live Longer

Dutch and British researchers have found that adding chest radiation to standard treatment helped people with advanced small cell lung cancer live longer and reduced the chances of the cancer coming back in the chest. The study’s authors are calling for chest radiation to be considered for everyone with extensive small cell lung cancer who has responded to chemotherapy.

Advanced small cell lung cancer can be very difficult to treat. These cancers often shrink for a time in response to chemotherapy, but they nearly always come back, either in the lungs or in other parts of the body, such as the brain or bones. Radiation therapy is often given to the head to help lower the risk of the cancer spreading to the brain, but chest radiation is not given routinely. It is used only to ease certain symptoms, such as bleeding, trouble swallowing, cough, shortness of breath, and bone pain.

The current trial involved 498 people in the Netherlands, the United Kingdom, Norway, and Belgium with advanced small cell lung cancer who had improved with chemotherapy treatment. They were randomly assigned to receive either radiation to the brain only, or radiation to the brain and chest.

After 2 years of follow-up, 13% of those treated with chest radiation were still alive compared with only 3% of those treated with standard care but no chest radiation. Also, 24% of those who had chest radiation survived for 6 months without their lung cancer getting worse compared with only 7% who did not have chest radiation. In addition, cancer came back in the chests of only 20% of those who had chest radiation compared with 46% of those who did not.

The study was published online September 14, 2014 in The Lancet and presented at the annual meeting of the American Society for Radiation Oncology (ASTRO) in San Francisco.

About 10% to 15% of people with lung cancer have small cell lung cancer, named for the size of the cancer cells when seen under a microscope. Other names for this type of lung cancer are oat cell cancer, oat cell carcinoma, and small cell undifferentiated carcinoma.

Small cell lung cancer often starts in the bronchi (air passages to the lungs) near the center of the chest. It tends to grow and spread quickly, and it has almost always spread to distant parts of the body before it is found.

The American Cancer Society medical and editorial content team
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Use of thoracic radiotherapy for extensive stage small-cell lung cancer: a phase 3 randomised controlled trial. Published online September 14, 2014 in The Lancet. First author Ben J. Slotman MD, VU University Medical Center, Amsterdam, Netherlands.


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