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No Better Survival With Early Lung Cancer Radiotherapy

Meta-analysis shows trend toward benefit of early radiotherapy with optimal chemo delivery

THURSDAY, Aug. 24 (HealthDay News) -- Contrary to some previous findings, the timing of thoracic radiotherapy (TRT) does not seem to impart a survival advantage among patients with limited disease small-cell lung cancer, according to findings in the Aug. 20 issue of the Journal of Clinical Oncology.

Stephen G. Spiro, M.D., of the London Lung Cancer Group in the U.K., and colleagues attempted to replicate the findings of an earlier National Cancer Institute of Canada trial that found early TRT did convey a significant survival advantage over late TRT.

In the new study, however, there was no difference in survival among patients who received early TRT administered with the second cycle of chemotherapy or late TRT with the sixth cycle. Only 69 percent of the patients in the early TRT arm received all six doses of chemotherapy, compared with 80 percent in the late arm, possibly because of the increased toxicity of the early arm. A meta-analysis did show a trend toward benefit from the optimal delivery of chemotherapy with early TRT.

"If one uses modern cisplatin-based chemotherapy in adequate doses with appropriate radiation therapy doses and ports, the timing of TRT is probably not a critical factor," concluded Michael C. Perry, M.D., of the Ellis Fischel Cancer Center in Columbia, Mo., in an accompanying editorial.

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