Stage IB NSCLC Patients With Poor Lung Function Benefit from

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Cancer News Article

Stage IB NSCLC Patients With Poor Lung Function Benefit from Intra-Operative Brachytherapy

Researchers from the University of Pittsburgh have reported that brachytherapy can prevent local recurrences in patients with stage IB non-small cell lung cancer (NSCLC) who undergo sublobar resection. The details of this report appeared in the February 2006 issue of the Annals of Thoracic Oncology .[1]

Patients with stage I-II NSCLC who cannot undergo surgery for medical reasons or who refuse surgery are usually treated with radiation therapy alone with results that are similar to surgery alone. However, there are other approaches to this problem. The authors of the current study have previously reported that patients with stage I NSCLC undergoing sublobar resection benefit from intra-operative 125Iodine brachytherapy compared to patients treated with surgery alone.[2]

In the current study these authors compared outcomes of 167 patients with stage IB NSCLC who underwent lobectomy with the outcomes of 41 patients with pulmonary compromise who underwent sublobar resection and intra-operative brachytherapy. The median follow-up of this trial was over 2 years. The local recurrence rate was 4.8% in the brachytherapy group and 3.2% in the lobectomy group. Disease-free survival at 4 years was 43% in the brachytherapy group and 42.8% in the lobectomy group. Overall survival at 4 years was 54.1% for the brachytherapy group and 51.8% for the lobectomy group. These authors concluded that sublobar resection with brachytherapy reduced local recurrences to rates observed following lobectomy.

Comments: These observations add to the options available to patients with stage I NSCLC who cannot tolerate lobectomy. How these results compare to external radiation without surgery would be of interest. Since distant recurrences are still a major problem in this group there may be a role for adjuvant chemotherapy as demonstrated in other studies.

Related News:

Chemoradiotherapy Promising for Stage I-II Non-Small Cell Lung Cancer (10/3/2005)

Radiation Improves Average Survival in Early, Unresected Non-Small Cell Lung Cancer (9/16/2005)

Large Clinical Trial Supports Use of Adjuvant Chemotherapy for Resected Stage I-III Non-Small Cell Lung Cancer (6/4/2003)

References

[1] Birdas TJ, Koehler RPM, Colonias A, et al. Sublobar resection with brachytherapy versus lobectomy for stage Ib non-small cell lung cancer. The Annals of Thoracic Surgery. 2006;81:434-439.

[2] Santos R, Colonias A, Parda D, et al. Comparison between sublobar resection and 125Iodine brachytherapy after sublobar resenction in high-risk patients with stage I non-small cell lung cancer. Surgery. 2003;134:691-697.