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High-Dose Radiation Comb/ w Chemotherapy Improves Survival


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Higher doses of radiation combined with chemotherapy improve survival in patients with stage III lung cancer, according to a new study by researchers at the University of Michigan Comprehensive Cancer Center.

Standard treatment for this stage of lung cancer -- when the tumor is likely too large to be removed through surgery -- involves a combination of radiation therapy with chemotherapy. But, this new study finds, giving chemotherapy at the same time as the radiation enhances the effect of both. Further, increasing the dose of radiation over the course of treatment also increased survival.

"When patients are diagnosed with stage III lung cancer, surgery is often not an option, and survival rates are typically quite low. Finding new ways to improve survival, even in small increments, is crucial," says senior study author Feng-Ming Kong, M.D., Ph.D., associate professor of radiation oncology at the U-M Medical School and chief of radiation oncology at the Ann Arbor VA Healthcare System.

The study, published in the April 1 issue of the International Journal of Radiation Oncology Biology Physics, looked at 237 patients who had been treated for stage III non-small cell lung cancer at U-M and the VA Ann Arbor.

The researchers compared survival among patients treated with radiation alone, with radiation followed by chemotherapy, and with radiation and chemotherapy given at the same time. Thirty-one of the patients were also enrolled in a study in which the radiation dose was increased throughout the course of the treatment.

Patients treated with radiation alone had the worst overall survival rates, living only an average 7.4 months after diagnosis. Adding chemotherapy increased survival to 14.9 months when it was administered after completing radiation and 15.8 months when administered at the same time as radiation. After five years, 19.4 percent of the patients receiving concurrent chemotherapy were still alive, compared to only 7.5 percent of patients receiving sequential chemotherapy.

"Our study shows chemotherapy helps, and high dose radiation helps. But it's challenging to administer these treatments at the same time because of the potential toxicity associated with the high dose radiation," Kong says.

U-M researchers are currently looking at using PET imaging during the course of lung cancer treatment to personalize high dose radiation therapy in many individual patients. As the tumor becomes smaller during treatment, increasing the radiation dose will become more tolerable because it is targeting a smaller area. The U-M researchers believe this strategy could lead to improved treatment outcomes in many patients. Kong currently leads a clinical trial that is following patients through their treatment to look at the impact on survival of increasing radiation dose.

Lung cancer statistics: 215,000 Americans will be diagnosed with lung cancer this year and 161,800 will die from the disease, according to the American Cancer Society

Additional authors: Li Wang, M.D., Ph.D.; Candace R. Correa, M.D.; Lujun Zhao, M.D., Ph.D.; James Hayman, M.D.; Gregory P. Kalemkerian, M.D.; Susan Lyons, M.D., Ph.D.; Kemp Cease, M.D.; and Dean Brenner, M.D.

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(Medical News Today, Lung Cancer; Radiology/Nuclear Medicine; Clinical Trials/Drug Trials, April 9, 2009)


The information contained in these articles may or may not be in agreement with my own opinions. They are not being posted with the intention of being medical advice of any kind.

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What these numbers also say:

On the average, concurrent chemo/radiation patients lived 27 days longer (9/10 of a month) than those with sequential therapies.

If we assume that the original 237 subjects were divided into 3 groups equally, that makes approximately 80 subjects per group, so...

...after 5 years, 15 of the 80 patients receiving concurrent therapies were still alive; after 5 years, 10 of the 80 receiving sequential therapies were still alive.

I'm NOT putting down the study -- just giving people a different way of looking at the numbers to help them decide their own course of action.

Barbara, thanks for posting, as always!


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Hi Ellen,

Bill is glad that he took the concurrent method.

Albeit, there have been side issues with mets, he has been (cross fingers) in pretty good shape after four years, four months since diagnosis.

Bill and I look at it this way, if at the end of the concurrent rad txs and chemo, he had been made surgically acceptable, as was proposed, perhaps that would have been a plus. We will never know.

We thought surgery would have been the result, but sigh it wasn't. Ah well, we play the hand we are dealt, Ellen.

Maybe I don't have a polka face and need more practice. :lol: I need to watch more Buster Keaton.


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Hi Barbara.

Oh, if I'd been told that chemo/rad would have made me possibly eligible for a stab at a cure (aka surgery), I certainly would have opted for it, and concurrently, if I were told that would be more effective. I can't imagine you and Bill making any other choice!


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Ellen, in our view, this "journey" with lung cancer has been a series of steps that have been strewn with lost chances, but replaced by new and hopeful tx "opportunities."

From the start, prior to Bill being diagnosed, it took a pulmonologist and a GP to continually drop the ball - all through the better part of a year.

I think I could have understood it better had Bill been someone who didn't keep up on his medical visits.

He went because I am a virtual nag in that department, and since he had colon cancer in 2001 (caught by his own keeping up on his colonoscopy visits) it was a no brainer for him to be vigilant about cancer. Cancer was a disease that took his mother, sister, and almost killed his kid brother - all different cancers.

We had to forget those original two doctors in order to begin anew with a different pulmonologist, who asked why we didn't go back to the original. I asked him if he would have after being delayed for almost a year.

There was no trust left in me for that nonsense. This new fellow was super, and told us that had he seen Bill originally, there would have been "a different story."

So, Ellen, when it came to treatment, anybody who suggested surgery might be in the offing, had my heart soaring more than a bit.

Of course, the story turned out differently, but somehow, Bill is still here (by the Grace of God) and hits each thing as it pops up.

He accepts the treatments because they have had only one side effect. He has a "certain" fatigue, but he works around it. He has never experienced anything more than that throughout.

I will say that there have been some junctures when his personality took a downward turn, but even that has returned to norm.

Looking at him, especially with the new head of hair, one would see dark brown hair with nary a gray thread.

One would take him for being a 78 1/2-year-old guy who had given up doing the lawn in favor of lesser energy-level activities. This year, the lawn company will be doing that.

As people have said to us regarding Bill, "It's about time he retired the lawnmower and the ladder."

I guess, Ellen, for anyone of us, it's a matter of choices and being in touch with our inner instincts, as to when to call a halt. Bill will know, but presently, The Good Lord Willing, it is not right now.

Once the Tarceva dosage was adjusted, he stepped right in with that regimen as though it were his natural, daily routine (showering with special body shampoo and creams for moisterizing). He still has the rash at the lower dose, but it is not as annoying anymore.

These posts, all of ours here, are helping people, in some way. I am sure of that. It makes lung cancer a disease we can talk about and not cloak in mystery.


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Like Donna, I received the simultaneous treatment of radiation w/2 chemo drugs. It was difficult but I became operable and appear very healthy today. I had a very aggressive radiologist who felt that delivery of the maximum doses possible was the best way to go.

I am very grateful and it seems miraculous. I hope others experience similar results.

Jackie M

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That is great, Jocelyn, and I hope there are many more who were able to be operable through the concurrent radiation/chemotherapy route.

That is certainly good news on your health.

Anytime there is such success, it has to have been "the best way to go."


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