Many people with lung cancer can be treated with a highly precise, high dose of radiation given in just one session without compromising the effectiveness of the treatment. The treatment strategy, outlined in a new publication authored by Singh et al in the International Journal of Radiation Oncology, Biology, Physics, could offer multiple benefits for many patients who cannot undergo lung cancer surgery, including fewer side effects from radiation exposure, less disruption to their lives and, possibly, lower medical costs.
When patients with early-stage lung cancer cannot undergo surgery because of their age, condition, or other reasons, typically they are treated with stereotactic body radiation therapy (SBRT), which precisely targets tumors to avoid damaging healthy tissue nearby. Lead author Anurag K. Singh, MD, of Roswell Park Comprehensive Cancer Center, along with co-authors from the Cleveland Clinic’s Taussig Center and the State University of New York Upstate Medical Center in Syracuse, looked at how well patients responded to treatment over a 6-year period. Data showed that reducing both the radiation dose and the number of treatment sessions resulted in the same long-term results as a higher dose delivered over more treatment sessions. They found that one session of SBRT at one-half the usual radiation dose worked just as well as three higher‑dose sessions. That means: “Single-fraction [SBRT] to peripheral lung tumors is cheaper, more convenient and just as effective [as the standard three fractions],” said Dr. Singh.
Study Findings
The phase II clinical trial followed 98 patients with early-stage NSCLC whose tumors were located in the outer parts of the lung and who were not able to undergo surgery. Participants were randomly assigned to one of two approaches:
- Three-fraction SBRT: 60 Gy delivered over three sessions
- Single-fraction SBRT: 30 Gy delivered in one session.
Patients were monitored regularly for up to 5 years. The research team found no meaningful differences between the two groups in survival, cancer recurrence, or side effects.
“This is an easy way to lower costs and increase convenience for patients without compromising on cancer control,” said Dr. Singh. “This approach may be even more important to those patients who must travel large distances to receive radiation.”
The study authors concluded, “This randomized phase II study demonstrated that 30 Gy in one fraction was equivalent to 60 Gy in three fractions in terms of toxicity, local failure, freedom from distal failure, progression-free survival, and overall survival.”
DISCLOSURE: For full disclosures of the study authors, visit redjournal.org.
