Comparision of overall survival for non-small cell lung cancer patients

May 31, 2010, Fox Chase Cancer Center

There's debate about the best treatment approach for patients with certain stages of non-small cell lung cancer (NSCLC), which accounts for about 80 percent of all lung cancers. Patients with early stages of NSCLC are typically treated with surgery, but those with stage IIIA present more of a challenge because they are such a diverse group. However, research from Fox Chase Cancer Center shows that patient's with stage IIIA NSCLC who receive surgery, lobectomy in particular, have increased overall survival compared to those who received chemoradiation alone--those receiving lobectomy plus chemoradation had survival rates that were higher than previously reported as well.

The research, led by Charu Aggarwal, M.D., M.P.H., Walter Scott, M.D., F.A.C.S., and George Simon, M.D., will be presented at the 46th Annual Meeting of the American Society of Clinical Oncology on Sunday June 6.

Stage IIIA presents challenges because patients classified at that level are such a diverse group. The common denominator is that cancer has spread to on the same side of the chest as the primary tumor, but beyond that, stage IIIA patients may have tumors of any size and may differ in the number and location of affected lymph nodes.

"In the past, patients with advanced stage lung cancer were treated either with alone, chemotherapy alone, or radiation alone," says Aggarwal. "Scientists and clinicians found that adding radiation to chemotherapy improved survival, so concurrent chemotherapy and radiation together became the standard of care." Recent large, Phase III clinical trials showed that patients treated with chemoradiation followed by surgery were more likely to be disease-free than counterparts who received chemoradiation without surgery set the stage for Aggarwal's study.

Looking at data from 249 patients treated at Fox Chase for stage IIIA non-small cell from 2000 through 2008, the research team divided patients into three groups based on the treatments they received: chemoradiation only, chemoradiation plus surgical removal of a lung (pneumonectomy), or chemoradiation plus surgical removal of only one lobe of the lung (lobectomy).

Biostatistician Brian Egleston, Ph.D., used a technique called propensity score analysis to balance the three groups in terms of age, gender, smoking status, physical condition, and other variables that could bias the results.

"After we adjusted for all those variables, we saw that patients who received surgery, lobectomy in particular, had increased overall survival compared to those who received chemoradiation alone," says Aggarwal. "We saw overall survival of 40 percent at five years for chemoradiation plus , higher than seen with pneumonectomy."

Removing the entire lung, a more extensive procedure that poses a greater risk of post-operative complications, offered no additional survival benefit." This tells us that you don't have to put the patient through pneumonectomy; you might get superior outcomes with a smaller, safer operation," says Aggarwal, who received an ASCO Foundation Merit Award for this research.

Related Stories

Recommended for you

Single blood test screens for eight cancer types

January 18, 2018
Johns Hopkins Kimmel Cancer Center researchers developed a single blood test that screens for eight common cancer types and helps identify the location of the cancer.

Researchers find a way to 'starve' cancer

January 18, 2018
Researchers at Vanderbilt University Medical Center (VUMC) have demonstrated for the first time that it is possible to starve a tumor and stop its growth with a newly discovered small compound that blocks uptake of the vital ...

How cancer metastasis happens: Researchers reveal a key mechanism

January 18, 2018
Cancer metastasis, the migration of cells from a primary tumor to form distant tumors in the body, can be triggered by a chronic leakage of DNA within tumor cells, according to a team led by Weill Cornell Medicine and Memorial ...

Modular gene enhancer promotes leukemia and regulates effectiveness of chemotherapy

January 18, 2018
Every day, billions of new blood cells are generated in the bone marrow. The gene Myc is known to play an important role in this process, and is also known to play a role in cancer. Scientists from the German Cancer Research ...

These foods may up your odds for colon cancer

January 18, 2018
(HealthDay)—Chowing down on red meat, white bread and sugar-laden drinks might increase your long-term risk of colon cancer, a new study suggests.

The pill lowers ovarian cancer risk, even for smokers

January 18, 2018
(HealthDay)—It's known that use of the birth control pill is tied to lower odds for ovarian cancer, but new research shows the benefit extends to smokers or women who are obese.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.