Brain Irradiation Decreases Incidence of Brain Metastases in Locally Advanced Lung Cancer Patients

Patients with locally advanced lung cancer who received a course of radiation therapy to their brain at the completion of their lung cancer treatment were less likely to develop brain metastases within the first year after treatment, according to new research.

Findings from the Radiation Therapy Oncology Group (RTOG; Philadelphia, PA, USA) study were presented at the American Society of Clinical Oncology annual meeting in Orlando, FL, USA, on June 1, 2009. RTOG, a U.S. National Cancer Institute- (NCI)-funded national clinical trials group, is a clinical research component of the American College of Radiology (ACR; Philadelphia. PA, USA).

As the treatment for locally advanced non-small cell lung cancer has improved, researchers are finding that patients have an increased risk of developing brain metastases without a relapse of their lung cancer. In order to develop a consensus on how to address this risk, RTOG initiated a phase III study to compare prophylactic cranial irradiation (PCI) versus observation in this patient population. Although the study, RTOG 0214, closed without meeting its accrual objective, an analysis of the 356 patients entered on the study found that patients who did not receive PCI were two and a half times more likely to develop brain metastases than those who did receive PCI.

"Although this study did not show a statistically significant difference in survival between the two groups of patients, we were able to show that PCI significantly decreased the incidence of brain metastases during the first year post-treatment,” said Elizabeth Gore, M.D., the lead author and principal investigator of the RTOG study from the Medical College of Wisconsin (Milwaukee, USA). "We plan a future analysis of the impact of PCI on neuropsychological function and quality of life and we expect that analysis will influence the recommendations regarding the standard use of PCI.”

RTOG is a multi-institutional international clinical cooperative group that conducts clinical trials and is comprised of over 300 major research institutions in the United States, Canada, and internationally. The group is currently accruing to 40 studies that involve radiation therapy alone or in conjunction with surgery and/or chemotherapeutic drugs or investigate quality of life issues and their effects on the cancer patient.

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