Brain radiation increases lung cancer survival

Preventive radiation to the brain significantly reduces the risk of lung cancer spreading to this organ and improves survival, according to data presented in a session Monday at the 43rd annual meeting of the American Society of Clinical Oncology.
All of the patients studied had advanced small-cell lung cancer, a type that carries a poor prognosis and is generally not amenable to surgical removal.
"Brain metastases are a common problem in small-cell lung cancer," study coordinator Dr. Ben Slotman, professor and chairman of radiation oncology at VU University Medical Center, Amsterdam, noted at a press briefing.
Previous studies have shown that brain radiation to prevent the cancer from invading this organ can extend survival in patients with limited small-cell lung cancer. The current study suggests that "all patients with small-cell lung cancer who respond to chemotherapy could benefit from" brain radiation, Slotman said.
In the study, 286 patients with advanced small-cell lung cancer and any response to chemotherapy were randomly assigned to preventative brain radiation or no radiation.
Preventative radiation was well tolerated; side effects were generally mild and consisted largely of headache, nausea/vomiting and fatigue, Slotman reported. Moreover, this treatment "did not adversely affect quality of life," he said.
Results showed that brain radiation significantly reduced the risk cancer spreading to the brain. After 1 year, there was brain involvement in 14.6 percent in the radiation group versus 40.4 percent in the comparison group.
Moreover, brain irradiation improved survival. At 1-year, the survival rate was 27.1 percent in the group that received preventative radiation compared to only 13.3 percent in the group that did not.
"Because improvements in treatment results for patients with advanced small-cell lung cancer have been minimal in the past two decades, these findings represent a significant advance," Slotman noted in a written statement.
Based on these findings, preventative radiation of the cranium should be "routinely be offered to all responding patients with (advanced) small-cell lung cancer," he told conference members.