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September 1, 2005

Researchers Find Chemotherapy and Radiation Together May Be Better for Patients with Locally Advanced Lung Cancer

Topics: Medicine

While researchers have learned in the last decade that combining chemotherapy with radiation is better than radiation alone for treating non-small cell lung cancer patients with locally advanced disease - cancer confined to the lungs - finding the right combination of drugs - and the best timing of treatment - has been tricky.

A new study led by lung cancer specialists at Jefferson Medical College adds to growing evidence that giving patients both chemotherapy and radiation in the beginning of treatment may help patients live longer. Non-small-cell lung cancer accounts for about 80 percent of all cases of lung cancer. An estimated 40,000 Americans are diagnosed each year with locally advanced disease.

This is a further step in looking at what is the best combination of two chemotherapy agents with radiation, which will enable us to move forward and study it more systematically," says Walter J. Curran Jr., M.D., professor and chair of radiation oncology at Jefferson Medical College at Thomas Jefferson University in Philadelphia and clinical director of Jefferson's Kimmel Cancer Center, who led the research.

"There are new biologic agents we want to test with chemotherapy, with radiation and with both," he notes. "Finding the best combination of chemotherapy and radiation provides a template by which we can test these agents.

The results appear September 1, 2005 in the Journal of Clinical Oncology.

In the multicenter, randomized phase 2 trial, researchers compared three different approaches to treating inoperable non-small-cell lung cancer that had not spread beyond the lungs. They divided more than 250 patients into three treatment arms. One group received chemotherapy before radiation. A second group had chemotherapy before and during radiation. Patients in the third arm received chemotherapy and radiation at the same time, then added a little more chemotherapy after. Each arm had the same schedule of radiation and were given the same two standard chemotherapy agents, carboplatin and paclitaxel.

Dr. Curran and his colleagues found that the patients in the third arm did best, living several months more on average when compared against the standard treatment.

There are 2 types of lung cancer: non-small cell lung cancer and small cell lung cancer. Non-small cell lung cancer includes squamous cell carcinoma, adenocarcinoma, and large cell carcinoma. Small cell lung cancer includes many different types of cells. The cancer cells of each type grow and spread in different ways. The types of small cell lung cancer are named for the kinds of cells found in the cancer and how the cells look when viewed under a microscope: Small cell carcinoma (oat cell cancer), mixed small cell/large cell carcinoma, and combined small cell carcinoma.

For most patients with non-small cell lung cancer, current treatments do not cure the cancer.

Posted by Richard at September 1, 2005 9:55 PM

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