Results of a study presented at this week's American Society for Therapeutic Radiology and Oncology (ASTRO) meeting indicate that brachytherapy for lung cancer patients can reduce local recurrence of the disease.
Researchers from Allegheny General Hospital in Pittsburgh reported on their most recent research, which involved brachytherapy conducted in conjunction with sublobar resection (SLR). Sublobar resection involves the removal of only the cancerous section of the lung in non-small cell lung carcinoma patients; it is more tolerable for patients but has a much higher risk of cancer recurrence than surgical removal of the entire lobe of the lung, according to Dr. Athanasios Colonias, the study's principal investigator.
The Allegheny researchers investigated whether the implantation of brachytherapy seeds at the surgical site to eradicate any remaining cancer cells could reduce SLR recurrence rates. They used a mesh material that was embedded with iodine-125 brachytherapy seeds and wrapped around the surgical site.
They examined the technique in a population of 145 high-risk patients with stage I non-small cell lung cancer (NSCLC) who were treated between January 1996 and February 2008. Local treatment failure was defined as a cancer recurrence within the involved lobe.
At a median follow-up of 38 months, Colonias and colleagues documented just six local recurrences (4.1%) with the group, compared to an expected cancer recurrence rate of 20% with SLR alone (based on previously published data). The team said that the results indicate that sublobar resection with intraoperative mesh brachytherapy could improve outcomes for high-risk NSCLC patients.
The group said that a large, randomized, multicenter clinical trial of the technique is under way to more definitively establish the efficacy of the procedure. The study is being coordinated by the American College of Surgeons Oncology Group (ACOSOG) and involves more than a dozen major U.S. hospitals, including Allegheny General Hospital.
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