15.09.14
New treatment recommendation for small-cell lung cancer
A low-cost radiation treatment could significantly prolong long-term survival for people with small-cell lung cancer (SCLC) and cut the likelihood of cancer recurrence in the chest by almost 50%, writes James Cartwright.
The new research published in ‘The Lancet’ today has indicated that the cancer would best be treated with thoracic radiation therapy alongside standard methods. The research was based on a study with a sample of 498 patients throughout hospitals in Norway, the UK, Belgium and the Netherlands – with 247 receiving thoracic radiation therapy and 248 receiving standard treatment over a period of two weeks (three withdrew informed consent).
The authors found that after the first year of treatment, survival rates were relatively similar – 33% in the thoracic radiotherapy group compared to 28% in the control group. However, results began to markedly diverge after 18 months, with survival rates marked at 16% to 9%. This was reinforced by the final two-year assessment, which found that 13% of patients given thoracic radiotherapy survived, compared to just 3% of those who had the standard treatment.
Coupled with the higher survival rates, patients receiving thoracic radiation therapy stood a higher chance of the disease not getting worse, with figures standing at 24% compared to 7% for the control group.
With thoracic radiation treatment described by patients as being well tolerated and with no severe acute or late toxic effects reported, the authors of this study have recommended that treatment be considered for patients with extensive SCLC who have responded to chemotherapy.
SCLC accounts for 13% of all lung cancer cases.
The report authors say: “Our findings suggest that the addition of thoracic radiotherapy after any response to chemotherapy in patients with extensive stage small-cell lung cancer leads to a significant reduction in intrathoracic recurrence and, despite the lack of a significant benefit in overall survival at one year, there were significant improvements in overall survival at two years and progression-free survival at six months.”
Jan P van Meerbeeck, of Ghent and Antwerp University, Belgium, and David Ball, of the University of Melbourne stated in an editorial linked with the study that as the treatment was not technically complex, it could easily be provided at low cost “in even the most modestly resourced radiotherapy departments”.
Funding for the study came from the Dutch Cancer Society (CKTO), Dutch Lung Cancer Research Group, Cancer Research UK, Manchester Academic Health Science Centre Trials Coordination Unit, and the UK National Cancer Research Network.
Professor Jane Maher, Joint Chief Medical Officer at Macmillan Cancer Support, said: "It’s really positive that these findings show it is possible to improve people’s chance of surviving such a life threatening form of cancer. Increasingly we know that combining treatments and encouraging different specialists to work together to deliver integrated treatment plans is very important for improving the outcome for cancer patients.
“Yet England has some of the poorest survival rates for cancer in Europe. If politicians are serious about improving survival rates it is crucial that they prioritise cancer care at the 2015 election and ensure that the best treatment is available on the NHS for people when appropriate.”
(Image: Micrograph of small cell lung cancer, FNA specimen, field stain. The image shows the key features of SCLC: nuclear moulding; salt and pepper chromatin; and scant cytoplasm. Image by Nephron. Creative Commons.)
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