Radiation Therapy after Surgery for Lung Cancer May Not Improve Survival ► NCI Cancer Bulletin for February 21, 2012 - National Cancer Institute

Radiation Therapy after Surgery for Lung Cancer May Not Improve Survival

Radiation treatment after surgery does not appear to improve the survival of some elderly patients with lung cancer, according to results from an NCI-supported study. The study looked specifically at patients ages 65 and older with stage III non-small cell lung cancer (NSCLC) that had spread to nearby lymph nodes. There was no difference in survival between patients in the study who received postoperative, or adjuvant, radiation therapy and those who did not. The study was published online February 13 in Cancer.
The study’s authors, led by Dr. Juan Wisnivesky of the Mount Sinai School of Medicine in New York, acknowledged that they could not determine from their work—a retrospective analysis of data on more than 1,300 patients in NCI’s SEER-Medicare database—whether adjuvant radiation therapy improved progression-free survival or quality of life.
Long-term survival is substantially decreased in patients with NSCLC that has spread to nearby lymph nodes, the authors noted, but there are no data from clinical trials to show that adjuvant radiation therapy improves survival in such patients, Dr. Wisnivesky noted in an interview.
Yet in this study, he continued, more than half of the patients received postoperative radiation therapy. The findings were the same even when the analysis was limited to patients in certain subgroups, such as those who also received postoperative chemotherapy or who were treated during different time periods. (The study covered patients treated from 1992 to 2005.)
“We were expecting that radiation therapy would be associated with improved survival. But we’ve shown that this is not the case, to the extent that we could with our data,” Dr. Wisnivesky said. “And [radiation] treatments are not without costs or risks.”
Because the study is retrospective with incomplete data, the findings should be interpreted with caution, stressed Dr. Giuseppe Giaccone of NCI’s Center for Cancer Research. Nevertheless, he said, the data support the idea that if there are any survival differences from adjuvant radiation, “they are likely to be small.”

A phase III clinical trial being conducted in Europe, called Lung ART, is testing whether post-surgical radiation in this same patient population improves overall survival.

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