Radiotherapy Approach Shows Potential as Lung Cancer Treatment

Bogart, M.D., professor and chair of the department of radiation oncology at the SUNY Upstate Medical University.

Dr. Bogart noted that an earlier study evaluated an approach of limited surgery on these patients, removing the tumor with only a small part of the diseased lung. However, while findings from this study indicated that limited surgery may be effective in certain patients, the role of limited surgical resection in the high-risk population remained unclear. This led investigators to assess a new hypothesis that would involve treating the tumor solely with dose-intensive accelerated three-dimensional conformal radiotherapy.

Conformal radiotherapy uses sophisticated technology to precisely target the tumor and the surrounding normal structures in three dimensions using computed tomography (CT) or magnetic resonance imaging (MRI) scans, and then sculpt the radiation dose to the shape of the tumor.

To conduct the study, 40 male and female stage 1 NSCLC patients, ranging in age from 48 years to 87, were recruited between 2001 and 2005. The radiotherapy schedule was decreased from 28 treatments in 5.5 weeks to 17 treatments in 3.5 weeks while maintaining a nominal dose of radiation of 7000 cGy. Dr. Bogart observed that just about 50% of all patients survived at least three years, a very promising result in this population.

Dr. Bogart noted that more studies are being planned to test new, non-surgical ways to treat this patient population. Especially exciting are recent developments at University Hospital that help account for the fact that many lung tumors move when a patient breathes. Technology such as four-dimensional CT (4DCT) scans, respiratory gating and image-guided radiotherapy (IGRT) work together to first identify how a lung tumor moves (by monitoring the patients unique breathing pattern) and then permits delivery of radiation only when the tumor is in the correct position.


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