Patients with locally advanced lung cancer who received a course of radiation therapy to the brain at the completion of their lung cancer treatment were less likely to develop brain metastases within the first year after treatment, according to research from the Radiation Therapy Oncology Group (RTOG) presented at the American Society of Clinical Oncology (ASCO) annual meeting in Orlando, FL.
The study (RTOG 0214) was open to patients with stage III non-small cell lung cancer without progression of disease after treatment that included surgery and/or radiation therapy, with or without chemotherapy. However, the targeted enrollment of 1,058 patients was not reached, according to principal investigator Dr. Elizabeth Gore, associate professor of radiation oncology at Medical College of Wisconsin in Milwaukee.
A total of 340 patients were enrolled in the study between September 2002 and August 2007. The study participants were randomized to prophylactic cranial irradiation or observation. They were stratified by tumor stage (IIIA or B), histology (nonsquamous or squamous), and surgery/no surgery. The patients who received prophylactic cranial irradiation received a daily dose of 2 Gy per fraction for 15 days, for a total of 30 Gy.
Disease-free survival and overall survival were comparable one year after treatment. Almost 76% of the cohort who received cranial irradiation were alive, and 56.4% had disease-free survival. For the observation only group, 76.9% were alive and 51.2% had disease-free survival.
The occurrence of central nervous system metastasis, however, was double for the group that was only being observed (18%), compared with the group that received cranial irradiation (7.7%). Logistic regression showed that the patients who did not receive this additional treatment were 2.52 times more likely to develop central nervous system metastases.
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