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Topic Name: Jefferson Researchers Show Chemotherapy and Radiation joinly increase Lung Cancer Patients’ Lives
Category: Biomedical
Research persons: Walter Curran Jr., M.D.
Location: Jefferson’s Kimmel Cancer Center, Philadelphia, United States
Details
Chemotherapy given at the same time as radiation therapy can help patients with a certain type of lung cancer live nearly 50 percent longer than they might have otherwise if the same treatment was given differently, according to an international team’s analysis of several trial results.
Walter Curran Jr., M.D., professor and chair of Radiation Oncology at Jefferson Medical College
of Thomas Jefferson University and Jefferson’s
Kimmel Cancer Center in Philadelphia, led one of six trials comparing the effectiveness of giving chemotherapy at the same time as radiation therapy versus giving radiation first, followed later by chemotherapy, to treat locally advanced non-small cell lung cancer (NSCLC).
According to Dr. Curran, there had been some controversy over whether simultaneous administration of chemotherapy and radiation for such cases was better than sequential delivery. In the United States, chemotherapy and radiation together have become the standard, whereas in other areas, such as Europe, for example, this has not been the case.
To try to resolve the matter, the International NSCLC Collaborative Group examined the results of more than 1,200 patients from six trials. The researchers found that the five-year survival rate was 10.6 percent with sequential therapy, while 15.1 percent with concurrent treatment. Dr. Curran presented the results last week at the meeting of the
American Society for Therapeutic Radiology and Oncology in Los Angeles.
“That means a relative increase of nearly 50 percent,” notes Dr. Curran, who led the Radiation Therapy Oncology Group (a Philadelphia-based cooperative clinical trials organization) trial. “We’ve demonstrated that the magnitude of benefit is observable in many studies, regardless of the regimen. I think it will be as persuasive as any data that this will change not only the tumor control rate but the chance for a long-term cure.”
Dr. Curran explains that the only difference in the two treatments is that radiation is begun at another time. The drugs and radiation techniques are the same. “You’re changing the first day of radiation from day 40 to day one, for example, and as a result, are changing the number of five-year survivors by between 40 percent and 50 percent,” he says. According to these findings, theoretically, if there were 50,000 patients, approximately 5,000 who received sequential therapies would be alive in five years, and with concurrent, about 7,500.
“It is a new standard of care,” he says about the results. “It’s relatively broadly adopted in this country, but across the world, it hasn’t been. This will be a very persuasive argument.”
Note for Chemotherapy
Chemotherapy is the use of chemical substances to treat disease. In its modern-day use, it refers to cytotoxic drugs used to treat cancer or the combination of these drugs into a standardized treatment regimen.
In its non-oncological use, the term may also refer to antibiotics (antibacterial chemotherapy). In that sense, the first modern chemotherapeutic agent was Paul Ehrlich's arsphenamine, an arsenic compound discovered in 1909 and used to treat syphilis. This was later followed by sulfonamides discovered by Domagk and penicillin discovered by Alexander Fleming.
Other uses of cytostatic chemotherapy agents (including the ones mentioned below) are the treatment of autoimmune diseases such as multiple sclerosis and rheumatoid arthritis and the suppression of transplant rejections (see immunosuppression and
DMARDs).
Note for Radiation therapy
Radiation therapy (or radiotherapy) is the medical use of ionizing radiation as part of cancer treatment to control malignant cells (not to be confused with radiology, the use of radiation in medical imaging and diagnosis). Radiotherapy may be used for curative or adjuvant cancer treatment. It is used as palliative treatment (where cure is not possible and the aim is for local disease control or symptomatic relief) or as therapeutic treatment (where the therapy has survival benefit but is not curative) Total body irradiation (TBI) is a radiotherapy technique used to prepare the body to receive a bone marrow transplant. Radiotherapy has a few applications in non-malignant conditions, such as the treatment of trigeminal neuralgia, severe thyroid eye disease, pterygium, prevention of keloid scar growth, and prevention of heterotopic ossification. The use of radiotherapy in non-malignant conditions is limited partly by worries about the risk of radiation-induced cancers.
Note for Lung cancer
Lung cancer is a disease where tissue in the lung grows out of control. This may lead to metastasis, invasion of adjacent tissue and infiltration beyond the lungs. The vast majority of primary lung cancers are carcinomas of the lung, resulting from epithelial cells. Lung cancer, the most common cause of cancer-related death in men and the second most common in
women, is responsible for 1.3 million deaths worldwide annually. The most common symptoms are shortness of breath, coughing (including coughing up blood), and weight
loss.
The main types of lung cancer are small cell lung carcinoma and non-small cell lung carcinoma. This distinction is important because the treatment varies; non-small cell lung carcinoma (NSCLC) is sometimes treated with surgery, while small cell lung carcinoma (SCLC) usually responds better to
chemotherapy.
About Researcher
Walter J. Curran Jr., M.D., FACR
Professor and Chairman, Radiation Oncology
Jefferson Medical College, Thomas Jefferson University Hospital.
Dr. Curran graduated cum laude from Dartmouth College, received his M.D. from the Medical College of Georgia and is a Board Certified Radiation Oncologist. Among other honors, he has received an American Cancer Society Fellowship and an ASTRO/ESTRO Travel Grant.
Interests: Lung Cancer, Brain Tumors,
Combined Modality Therapy
Contact:
111 South 11th Street
Philadelphia, PA 19107-5097
Phone (215) 955-6701
Fax (215) 955-0412
Email: walter.curran@mail.tju.edu
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