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Patients with early stage, non-small cell lung cancer who are not able to undergo surgery, now have a highly effective treatment option. Physicians say that option, radical stereotactic radiosurgery performed with CyberKnife, leads to a 100% overall survival after three years in patients with good lung function before treatment.
These are the results of a study presented at the annual CHEST meeting in San Diego, US. The study is a semifinalist for an Alfred Soffer Research Award, selected for "outstanding original scientific research."
Surgery not an option
For patients with small tumours characterised as early-stage disease, surgical removal of the affected lobe (lobectomy) is the standard of care. However, surgery is sometimes not an option because of other pre-existing medical conditions such as emphysema or heart disease.
"Our goal has been to find a reasonable option for patients who don't want or can't tolerate surgery," says the study's lead author, Dr Brian T. Collins, a radiation oncologist with the Lombardi Comprehensive Cancer Centre at Georgetown University Hospital, US. "What we discovered is a very promising option that may be relevant for other stage one patients as well. More follow up with these patients is planned to see how they progress five years after treatment."
The study
Twenty-four patients were treated as part of the study. Each patient's "forced expiratory volume in one second" or FEV1was measured.
"We use the FEV1 to grade the severity of a patient's COPD," says Dr Eric D. Anderson, a pulmonologist at Georgetown University Hospital. "It measures the ability of a patient to exhale forcefully."
At an average follow up of 36 months, the overall survival for all patients was 79% with five deaths occurring due to progressive lung dysfunction. For patients with a better FEV1, survival was 100%.
Treatment well tolerated
Collins says the treatment was well tolerated with mild fatigue only reported by the majority of patients.
"What we also learned from this study is that patients with poorer lung functioning don't do nearly as well," Collins explained. The overall survival in this group of patients was only 30%.
"This information is important for the doctor and patient when making treatment decisions," says Collins. "In treating someone with poor lung function, it would seem prudent to modify the treatment dose in order to reduce further damage to the lungs that stereotactic radiosurgery causes." - (EurekAlert!, November 2009)
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Cancer of the Lung
