In a study from Upstate Medical University, scientists did a clinical trial that may have major implications for the treatment of small-cell lung cancer.
The study is the largest trial in limited-stage small-cell lung cancer ever performed, and it suggests similar outcomes and long-term survival in patients treated with twice-a-day versus once-a-day radiotherapy.
Previously, the twice-a-day regime was recommended as standard, based on prior trials, but many patients were not able to receive twice-a-day radiation in part due to the challenge of coming in for appointments two times each day.
In the study, the team tested more than 700 patients throughout the United States from 2008 to 2019. About 30,000 people are diagnosed with small-cell lung cancer each year.
That type of cancer, which is treated with chemotherapy and radiation, accounts for about 15 to 20 percent of all lung cancer patients.
The earlier trial showed that radiation administered twice a day for three weeks was a more effective treatment than the same dose of radiation once a day for five weeks.
Despite undergoing radiation for a shorter period of time—three weeks compared to five—receiving two doses of radiation in one day is difficult for many patients.
Twice daily radiation must be administered at least six hours apart, which means the patient has to be at the hospital twice in one day. That’s a tiring regimen and can be difficult for those who don’t live nearby.
And even though that was the recommended regimen, only 15 percent of patients nationwide opted for twice-daily radiation treatments.
The current study showed that a higher dose of radiation given once a day over seven weeks showed no statistical difference in survival rates than the twice-a-day regimen.
The team says the technology today is so much more advanced than it was 30 years ago, including very focused treatment with image guidance that can produce targeted radiation, resulting in fewer side effects.
The study results now allow for two equal options for patients.
It allows patients a real choice, understanding that there may be some differences in side effects, or their ability to complete the longer therapy, but now they know both regimens can be associated with good outcomes.
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The study was conducted by Dr. Jeffrey Bogart et al and published in the Journal of Clinical Oncology.
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