Late consolidative radiation therapy in the treatment of limited-stage small cell lung cancer

Article Abstract:

The various types of lung cancer, classified on the basis of their appearance under the microscope, also differ in their biological behavior. Small cell lung cancer is more susceptible to chemotherapy and radiation than are the other types that are often collectively called non-small cell lung cancers. However, small cell lung cancer is also more likely to metastasize early in the course of the disease, limiting the usefulness of surgery. In patients in the earlier stages of small-cell lung cancer, the complete response rate to combination chemotherapy may be as high as 65 percent. However, most of these patients relapse, and the median survival time is probably no longer than 18 months. The two-year survival rate is between 15 and 25 percent. Researchers have evaluated the role of consolidative radiation therapy in small-cell lung cancer that is still in limited stages. In this procedure, the patient receives combination chemotherapy, and then the cancerous area is exposed to radiation treatment. A total of 223 patients participated in a comparison of chemotherapy with consolidative radiation to chemotherapy alone; 180 patients were available for complete follow-up. Only a minority of these patients were randomized as part of the experimental design. The results indicate that the addition of consolidative radiotherapy to the treatment protocol is well-tolerated. However, there is only a marginal improvement in the local control of the lung cancer. Patients treated with consolidative radiation therapy had a slightly longer time to progression, but the difference was not statistically significant. There was no significant difference in survival between those who received consolidative radiation and those who did not. In the present series of patients, the median survival time was just under one year. The two-year survival rate was 16 percent, and the five-year survival rate was 11 percent. (Consumer Summary produced by Reliance Medical Information, Inc.)

Prognosis, Lung cancer, Small cell, Small cell lung cancer

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Radiotherapy alone and chemoradiation for nonmetastatic esophageal carcinoma: a critical review of chemoradiation

Article Abstract:

The effectiveness of radiotherapy alone or radiotherapy combined with chemotherapy was examined in a study of 65 patients with nonmetastatic esophageal cancer of stages I through III. The group that received only radiation consisted of 35 patients who received between 56 and 61 Gy over a six to seven week period. The group treated with radiotherapy and chemotherapy received a slightly lower dose of radiation, 41.4 to 50.4 Gy, with simultaneous administration of 5-fluorouracil, mitomycin C, and cisplatin, along with maintenance chemotherapy of methotrexate, leucovorin, and 5-fluorouracil. Two patients in the group that received radiation alone are alive and well, compared with 12 who are alive and well in the radiotherapy and chemotherapy group. In patients that achieved a complete response, the median survival for radiotherapy alone was eight months; median survival for the combination group was 15 months. The combination of radiotherapy and chemotherapy is more effective than either surgery alone or radiotherapy alone, although the overall improvement in survival is marginal. Further research should be focused on improvements in the combination of radiotherapy and chemotherapy for the treatment of esophageal cancer. (Consumer Summary produced by Reliance Medical Information, Inc.)

Chemotherapy

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Thermo-chemo-radiotherapy of esophageal cancer: a preliminary report of 34 cases

Article Abstract:

Combined treatments may sometimes yield benefits that may not be possible by any single treatment alone. Thirty-four cases of esophageal cancer were treated with a combination of hyperthermia, in which the tumor is heated with microwaves, chemotherapy, and radiotherapy. Six weekly treatment sessions consisted of 20 milligrams (mg) of bleomycin, 1.0 to 1.5 mg per kilogram of body weight of cisplatin, tumor microwave heating to between 44 and 48.5 degrees centigrade, and 500 centiGrays (cGy) of tumor radiation (1 Gy = 100 rads). At the end of one year, 74 percent of the patients survived, and 44 percent survived with no evidence of disease at the end of two years. An interesting observation is the apparent relationship between microwave power absorption and survival. Nine patients showed an increase in microwave power absorption during the six weeks of treatment; seven of these patients had survived at two years with no evidence of disease. Of the 11 patients who did not show an increase in power absorption, only four survived two years later. (Consumer Summary produced by Reliance Medical Information, Inc.)

Cancer, Cancer treatment, Thermotherapy, Adjuvant chemotherapy

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