SBRT may be effective, safe alternative for patients, medically inoperable early-stage lung cancer

July 5, 2018, NRG Oncology

JAMA Oncology recently published data from NRG Oncology's RTOG 0618 trial [clinicaltrials.gov identifier NCT00551369], which shows that the utilization of Stereotactic Body Radiation Therapy (SBRT) as a treatment for medically operable lung cancer is associated with favorable primary tumor control and local control rates.

"The current standard therapy for this patient population is surgical resection because cure rates have been highest, but even for operable , surgery can be challenging," stated Robert D. Timmerman, MD, from the Department of Radiation Oncology at the University of Texas Southwestern Medical Center in Dallas and the lead author of the publication. "We began NRG-RTOG 0618 building on the work we did with SBRT in medically inoperable early-stage lung cancer. We hypothesized that this newer treatment method might also effectively cure operable lung cancer, potentially giving patients another option."

The single-arm, phase II NRG-RTOG 0618 trial, accrued patients from December 2007 to May 2010 with a median follow up of 48.1 months. The primary endpoint of the trial was control with secondary endpoints that included survival, , incidence and outcome of surgical salvage. 26 patients were evaluable of those accrued to the trial. After receiving SBRT at 54 Gy delivered in three 18 Gy fractions over one and a half to two weeks, only one patient experienced primary tumor recurrence. This patient underwent salvaged lobectomy that was complicated by Grade 4 cardiac arrhythmia and recovered, but developed metastatic disease approximately four months later and died two years after salvage surgery. Estimated 4-year primary tumor control and local control rate were both 96%. Involved lobe failure did not occur in any patients. Protocol-specified treatment-related grade 3 adverse events were reported in two patients with no patients reporting Grade 4 or 5 adverse events.

In NRG-RTOG 0618, control was achieved with a relatively low rate of toxicity and, due to high intrathoracic ; the need for surgical salvage was low. This trial results suggest that SBRT may be a viable alternative to surgery for patients with medically operable, early-stage lung cancer; however, this would need to be compared in a phase III, randomized trial. At this time, several trials are underway and enrolling for this patient population.

Explore further: Long-term results of RTOG 0236 confirm good primary tumor control, positive five-year survival rates

More information: Robert D. Timmerman et al, Stereotactic Body Radiation Therapy for Operable Early-Stage Lung Cancer, JAMA Oncology (2018). DOI: 10.1001/jamaoncol.2018.1251

Related Stories

Long-term results of RTOG 0236 confirm good primary tumor control, positive five-year survival rates

September 16, 2014
Patients with inoperable, early-stage lung cancer who receive stereotactic body radiation therapy (SBRT) have a five-year survival rate of 40 percent, according to research presented today at the American Society for Radiation ...

Comparable patterns of failure between SBRT, lobectomy or pneumonectomy for stage I NSCLC

January 15, 2013
For patients with medically operable clinical stage I non–small-cell lung cancer (NSCLC), lobectomy or pneumonectomy is the standard approach. For patients with medically inoperable stage I NSCLC, stereotactic body radiotherapy ...

Sustained local control for medically inoperable, early stage lung cancer patients

October 30, 2014
Analysis of data from an institutional patient registry on stereotactic body radiotherapy (SBRT) indicates excellent long-term, local control, 79 percent of tumors, for medically inoperable, early stage lung cancer patients ...

'Aggressive' surgery is best treatment option for early stage lung cancer

November 30, 2017
Patients with early stage lung cancer live longer when they receive a lobectomy—the most common type of operation for the disease—rather than a less extensive operation or radiation treatment, according to a study published ...

ASTRO issues guideline for use of stereotactic radiation in early-stage lung cancer

June 12, 2017
The American Society for Radiation Oncology (ASTRO) issued a new clinical guideline for the use of stereotactic body radiation therapy (SBRT) in early-stage lung cancer today. While SBRT is the current standard of care for ...

Recommended for you

DNA vaccine leads to immune responses in HPV-related head and neck cancer

September 21, 2018
A therapeutic vaccine can boost antibodies and T cells, helping them infiltrate tumors and fight off human papillomavirus (HPV)-related head and neck cancer. Researchers from the Abramson Cancer Center of the University of ...

In zebrafish, a way to find new cancer therapies, targeting tumor modulators

September 21, 2018
The lab of Leonard Zon, MD, at Boston Children's Hospital has long been interested in making blood stem cells in quantity for therapeutic purposes. Looking for a way to test for their presence in zebrafish, their go-to research ...

What can salad dressing tell us about cancer? Think oil and vinegar

September 20, 2018
Researchers led by St. Jude Children's Research Hospital scientists have identified another way the process that causes oil to form droplets in water may contribute to solid tumors, such as prostate and breast cancer. The ...

Novel biomarker found in ovarian cancer patients can predict response to therapy

September 20, 2018
Despite months of aggressive treatment involving surgery and chemotherapy, about 85 percent of women with high-grade wide-spread ovarian cancer will have a recurrence of their disease. This leads to further treatment, but ...

Testing fluorescent tracers used to help surgeons determine edges of breast cancer tumors

September 20, 2018
A team of researchers with members from institutions in The Netherlands and China has conducted a test of fluorescent tracers meant to aid surgeons performing tumor removal in breast cancer patients. In their paper published ...

Cancer immunotherapy might benefit from previously overlooked immune players

September 20, 2018
Cancer immunotherapy—efforts to boost a patient's own immune system, allowing it to better fight cancer cells on its own—has shown great promise for some previously intractable cancers. Yet immunotherapy doesn't work ...

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.