Intensity-modulated radiation therapy (IMRT) should be the preferred choice when treating patients with locally advanced non-small cell lung cancer (NSCLC), as it reduces radiation exposure to the heart and lungs, according to researchers at The University of Texas MD Anderson Cancer Center.
Results from a long-term secondary analysis of the NRG Oncology-RTOG 0617 Phase III study, with a median follow-up of 5.2 years, revealed that patients receiving IMRT had a more than two-fold reduction in severe lung inflammation (pneumonitis) compared to those who received 3D-conformal radiotherapy (3D-CRT), 3.5% versus 8.2%.
The findings were presented at the at the International Association for the Study of Lung Cancer 2023 World Conference on Lung Cancer by Stephen Chun, M.D., associate professor of Radiation Oncology.
The NRG Oncology-RTOG 0617 study enrolled 482 NSCLC patients from 2007 to 2011 and compared a high dose of radiation (74 Gy) to a standard dose (60 Gy). All patients underwent concurrent chemotherapy (carboplatin/paclitaxel, with or without cetuximab) and either 3D-CRT (53%) or IMRT (47%).
Although patients treated with both techniques had similar survival rates, closer inspection of the data demonstrated a correlation between survival and radiation exposure to the heart. IMRT treatment plans achieved significantly lower cardiac radiation doses.
Both the 3D-CRT and IMRT groups had similar rates of new cancer development over time. Scientists also saw no evidence that age impacted survival, meaning that age is no reason to exclude elderly patients from curative-intent chemoradiation for locally advanced NSCLC.
The University of Texas MD Anderson Cancer Center release on Newswise
