Nav: Home

SBRT may be effective, safe alternative for patients, medically inoperable early-stage lung cancer

July 05, 2018

JAMA Oncology recently published data from NRG Oncology's RTOG 0618 trial [clinicaltrials.gov identifier NCT00551369], which shows that the utilization of Stereotactic Body Radiation Therapy (SBRT) as a treatment for medically operable lung cancer is associated with favorable primary tumor control and local control rates.

"The current standard therapy for this patient population is surgical resection because cure rates have been highest, but even for operable patients, surgery can be challenging," stated Robert D. Timmerman, MD, from the Department of Radiation Oncology at the University of Texas Southwestern Medical Center in Dallas and the lead author of the publication. "We began NRG-RTOG 0618 building on the work we did with SBRT in medically inoperable early-stage lung cancer. We hypothesized that this newer treatment method might also effectively cure operable lung cancer, potentially giving patients another option."

The single-arm, phase II NRG-RTOG 0618 trial, accrued patients from December 2007 to May 2010 with a median follow up of 48.1 months. The primary endpoint of the trial was primary tumor control with secondary endpoints that included survival, adverse events, incidence and outcome of surgical salvage. 26 patients were evaluable of those accrued to the trial. After receiving SBRT at 54 Gy delivered in three 18 Gy fractions over one and a half to two weeks, only one patient experienced primary tumor recurrence. This patient underwent salvaged lobectomy that was complicated by Grade 4 cardiac arrhythmia and recovered, but developed metastatic disease approximately four months later and died two years after salvage surgery. Estimated 4-year primary tumor control and local control rate were both 96%. Involved lobe failure did not occur in any patients. Protocol-specified treatment-related grade 3 adverse events were reported in two patients with no patients reporting Grade 4 or 5 adverse events.

In NRG-RTOG 0618, tumor control was achieved with a relatively low rate of toxicity and, due to high intrathoracic control; the need for surgical salvage was low. This trial results suggest that SBRT may be a viable alternative to surgery for patients with medically operable, early-stage lung cancer; however, this would need to be compared in a phase III, randomized trial. At this time, several trials are underway and enrolling for this patient population.
-end-
Supported by: Grants U10CA21661, U10CA180868, U10CA180822 and CA81647 from the National Cancer Institute (NCI)

Citation:

Timmerman RD, Paulus R, Pass HI, Gore EM, Edelman MJ, Galvin J, Straube WL, Nedzi LA, McGarry RC, Robinson CG, Schiff PB, Chang G, Loo BW Jr, Bradley JD, Choy H. Stereotactic Body Radiation Therapy for Operable Early-Stage Lung Cancer: Findings From the NRG Oncology RTOG 0618 Trial. JAMA Oncol. 2018 May 31. doi:10.1001/jamaoncol.2018.1251. [Epub ahead of print] PubMed PMID: 29852037.

http://www.nrgoncology.org

NRG Oncology conducts practice-changing, multi-institutional clinical and translational research to improve the lives of patients with cancer. Founded in 2012, NRG Oncology is a Pennsylvania-based nonprofit corporation that integrates the research of the National Surgical Adjuvant Breast and Bowel Project (NSABP), the Radiation Therapy Oncology Group (RTOG), and the Gynecologic Oncology Group (GOG). The research network seeks to carry out clinical trials with emphases on gender-specific malignancies, including gynecologic, breast, and prostate cancers, and on localized or locally advanced cancers of all types. NRG Oncology's extensive research organization comprises multidisciplinary investigators, including medical oncologists, radiation oncologists, surgeons, physicists, pathologists, and statisticians, and encompasses more than 1,300 research sites located world-wide with predominance in the United States and Canada. NRG Oncology is supported primarily through grants from the National Cancer Institute (NCI) and is one of five research groups in the NCI's National Clinical Trials Network.

NRG Oncology

Related Surgery Articles:

Bullies and their victims more likely to want plastic surgery
11.5 percent of bullying victims have extreme desire to have cosmetic surgery, as well as 3.4 percent of bullies and 8.8 percent of teenagers who both bully and are bullied -- compared with less than 1 percent of those who are unaffected by bullying.
Methadone may reduce need for opioids after surgery
Patients undergoing spinal fusion surgery who are treated with methadone during the procedure require significantly less intravenous and oral opioids to manage postoperative pain, reports a new study published in the May issue of Anesthesiology, the peer-reviewed medical journal of the American Society of Anesthesiologists (ASA).
New, persistent opioid use common after surgery
Among about 36,000 patients, approximately 6 percent continued to use opioids more than three months after their surgery, with rates not differing between major and minor surgical procedures, according to a study published by JAMA Surgery.
Refusing access to surgery recovery area at a UK hospital unless WHO Safe Surgery Checklist is fully complete
New research showing that refusal to allow surgery teams to take the patient to the recovery room after surgery unless the full WHO Safe Surgery Checklist has been complete is a highly effective way to improve use of the checklist.
Robotic surgery just got more autonomous
Putting surgery one step closer into the realm of self-driving cars and intelligent machines, researchers show for the first time that a supervised autonomous robot can successfully perform soft tissue surgery.
Ultrasonic surgery reduces pain and swelling after chin surgery
For patients undergoing plastic surgery of the chin (genioplasty), the use of ultrasonic 'piezosurgery' equipment reduces trauma, pain, and swelling, compared to traditional surgical drills, reports a study in the The Journal of Craniofacial Surgery.
Annual plastic surgery statistics reflect the changing face of plastic surgery
The annual plastic surgery procedural statistics from the American Society of Plastic Surgeons (ASPS), show that in 2015 there were 15.9 million surgical and minimally invasive cosmetic procedures performed in the United States -- up 2 percent from 2014.
Orthopedic surgery simulation
A unique training simulator for orthopedic open surgery (knee reconstruction with total joint replacement) has been developed by OSSim Technologies Inc. in partnership with three University of Montreal orthopedic surgeons.
Forum on how surgery can improve healthcare in SA
A national forum on surgery and anaesthesia and how it is an indispensable part of achieving universal health coverage will take place on Dec.
Meniscus injury: Real surgery or sham surgery -- which is better for patients?
Should the non-surgical approach be preferred over surgical treatment or are there still advantages offered by surgery.

Related Surgery Reading:

Best Science Podcasts 2019

We have hand picked the best science podcasts for 2019. Sit back and enjoy new science podcasts updated daily from your favorite science news services and scientists.
Now Playing: TED Radio Hour

Bias And Perception
How does bias distort our thinking, our listening, our beliefs... and even our search results? How can we fight it? This hour, TED speakers explore ideas about the unconscious biases that shape us. Guests include writer and broadcaster Yassmin Abdel-Magied, climatologist J. Marshall Shepherd, journalist Andreas Ekström, and experimental psychologist Tony Salvador.
Now Playing: Science for the People

#513 Dinosaur Tails
This week: dinosaurs! We're discussing dinosaur tails, bipedalism, paleontology public outreach, dinosaur MOOCs, and other neat dinosaur related things with Dr. Scott Persons from the University of Alberta, who is also the author of the book "Dinosaurs of the Alberta Badlands".