Recent studies suggest that patients with early stage, non-small cell lung cancer who are not able to undergo surgery now have another option. Physicians say that option, radical stereotactic radiosurgery performed with CyberKnife, leads to a 100 percent overall survival after three years in patients with good lung function before the treatment. These are the results of a study presented at the annual American College of Chest Physicians meeting in San Diego.
For patients with small tumors characterized as early-stage disease, surgical removal of the affected lobe (lobectomy) is the standard of care. However, surgery is sometimes not an option because of other pre-existing medical conditions such as emphysema or heart disease.
“Our goal has been to find a reasonable option for patients who don't want or can't tolerate surgery,” says the study's lead author, Brian T. Collins, MD, a radiation oncologist with the Lombardi Comprehensive Cancer Center at Georgetown University Hospital. “What we discovered is a very promising option that may be relevant for other stage one patients as well. “
Twenty-four patients were treated as part of the study. Each patient's “forced expiratory volume in 1 second”, or FEV1, was measured. “We use the FEV1 to grade the severity of a patient's COPD,” says Eric D. Anderson, MD, a pulmonologist at Georgetown University Hospital and presenting author of the abstract. “It measures the ability of a patient to exhale forcefully.” COPD stands for Chronic Obstructive Pulmonary Disease, or emphysema.
At an average follow up of 36 months, the overall survival for all patients was 79 percent with five deaths occurring due to progressive lung dysfunction. For patients with a better FEV1, survival was 100 percent. Collins says the treatment was well tolerated with mild fatigue only reported by the majority of patients.
“This information is important for the doctor and patient when making treatment decisions,” says Collins. “In treating someone with poor lung function, it would seem prudent to modify the treatment dose in order to reduce further damage to the lungs that stereotactic radiosurgery causes.”
Lung cancer is the leading cause of cancer deaths with more than 215,020 people diagnosed each year and 161,804 dying of the disease, according to the American Cancer Society.