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Higher-dose RT results in inferior survival in patients with stage III lung cancer
Date:5/29/2013

In a randomized phase III clinical trial conducted by the Radiation Therapy Oncology Group (RTOG), high-dose (HD), compared with standard-dose (SD), radiotherapy (RT) with concurrent chemotherapy (CT) did not improve overall survival of patients with stage III non-small-cell lung cancer (NSCLC).

Philadelphia, PAOf all the patients in the US with lung cancer, the country's leading cause of cancer death, 75 to 80 percent of them have NSCLC, with 30 to 40 percent of those being considered locally advanced (stage IIIA or IIIB). Although RT plus CT has been the standard of care for locally advanced NSCLC, more research has focused on the incorporation of appropriate CT drugs than on revisiting the 60-Gy RT dose established over 30 years ago. Concern over local tumor progression rates near 85 percent following treatment for stage III NSCLC with CT plus conventional RT doses and research results showing increased median survival time associated with a 74-Gy RT dose led to the development of RTOG 0617, which sought to identify the optimal RT dose for the treatment of patients with locally advanced NSCLC. The trial additionally tested the hypothesis that the addition of cetuximab, a drug that targets the epidermal growth factor receptor (EGFR) pathway and has radiation-sensitizing properties, to chemoradiation would lead to improved survival.

The trial randomized 464 patients with pathologically diagnosed unresectable stage IIIA or IIIB NSCLC to SD (60 Gy) or HD (74 Gy) arms. All patients received concurrent CT of weekly paclitaxel and carboplatin, as well as additional cycles of consolidation CT following combined CT and RT.

The trial's final results on radiation dose will be presented Tuesday, June 4 at the American Society of Clinical Oncology 2013 Annual Meeting by Principal Investigator (PI) Jeffrey D. Bradley, M.D., a professor in radiation oncology, and chief of thoracic service at Washington University School of Medicine in St. L
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Contact: Shawn Farley
PR@acr.org
703-648-8936
American College of Radiology
Source:Eurekalert

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