3D-Conformal Radiation Therapy Shows Potential in Early

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Stage Lung Cancer: Presented at ICACT

http://www.docguide.com/news/content.ns ... 06006DD6BF

By Jill Stein

PARIS, FRANCE -- January 30, 2006 -- Use of 3-dimensional (3D)-conformal radiation therapy (CRT) using a middle fraction size for the management of stage I non-small-cell lung cancer (NSCLC).

These findings are based on a Japanese study of 53 patients which found that the 3D-CRT technique was associated with good local control and overall survival rates as well as acceptable toxicity.

Yurie Kiguchi, MD, staff radiation oncologist at Tokyo Metropolitan Hospital, Tokyo, Japan, presented the study here on January 30th at the 17th International Congress on Anti-Cancer Treatment (ICACT).

"The rates of lung cancer and mortality from lung cancer is increasing in Japan and will continue to increase with the trend towards an aging population," Dr. Kiguchi said. "In fact, in about 10 years, about 70% of all lung cancer patients will be elderly. For this reason, the need for noninvasive treatment strategies becomes increasingly important."

Because of poor results with conventional radiotherapy, Dr. Kiguchi and colleagues decided to examine the use of 3D- CRT with the goal of improving treatment results.

"We had hoped that concentrating a higher radiation dose to the target volume might improve the control rate while minimizing the high radiation dose to surrounding lung tissue might decrease adverse events," he said.

All patients in his series were inoperable or had refused surgery and had a tumor diameter that did not exceed 5 cm and an ECOG performance status of 3 or better with a V20 under 20%.

Patients received underwent a mean duration of treatment of 36 days.

At the 1 year evaluation, 98.1% of patients were alive, and 74.5% were alive at 3 years. Local control rates were 100% at 1 year and 81.9% at 3 years.

Patients with T1 lung cancer had a 1-year survival rate of 89.5% and a 3-year survival rate of 71.2%. Local control rates were 100% and 87.2%, respectively.

Dr. Kiguchi said that treatment toxicity was acceptable. Two patients developed grade 2 and four patients developed grade 3 lung toxicity. All six patients had pulmonary toxicity before undergoing 3D-CRT.

Four patients had died of primary disease, and two had died of other forms of cancer. Three died of intercurrent disease, Dr. Kiguchi said.

"This treatment might become the standard treatment option for inoperable stage I NSNLC though a larger number of patients and longer follow-up are necessary," Dr. Kiguchi said.

[Presentation title: Prospective Study of Three-Dimensional Conformal Radiation Therapy (3D-CRT) for the Treatment of Stage 1 Non-Small-Cell Lung Cancer.]