Advanced radiotherapy linked to improved survival rates among elderly lung cancer patients

Advanced radiotherapy linked to improved survival rates among elderly lung cancer patients

The latest issue of the journal Annals of Oncology reports that a major new study by one of the country's leading cancer centers, the VU University Medical Center (VUMC) in Amsterdam has revealed that widespread use of advanced radiotherapy techniques in the Netherlands has resulted in improved survival rates amongst elderly lung cancer patients.

Until now, the VUMC has treated over a thousand patients for pulmonary tumors with stereotactic ablative radiotherapy (SABR). Varian Medical Systems supplied the machines for the SABR treatment.

Dr. Niels Haasbeek from VUMC's department of radiation oncology, the first author of the publication, states:

"The greater use of advanced radiotherapy techniques have led to large improvements in survival for Dutch lung cancer patients over the age of 75, many of whom are too frail to undergo surgery. Those patients in this age group who are fit enough for surgery should also be informed about the curative option of SABR as an alternative to surgery."

Even though worldwide lung cancer is the most common cause of cancer, improvements in overall survival rates have been minimal over the last few decades. For instance, the five-year survival rate for non small-cell lung cancer (NSCLC) increased by only 3% from 13% in 1975-1977 to 16% by 1999-2005.

Researchers from the VUMC conducted a nationwide study applying the expertise they gained in several years of advanced radiotherapy for early-stage lung cancer patients to examine stereotactic body radiotherapy (SABR) affects on survival rates.

SBRT is a treatment method in which the tumor is targeted with a high-energy radiation beam in order to damage tumor cell DNA and kill the cancer cell.

The VUMC team has treated over 800 stage-1 lung tumor patients within the last nine years, most of them using SABR. The clinic receives referrals from over 70 Dutch hospitals and treats patients on six Varian linear accelerators, two of which are TrueBeam™ devices and one is a Novalis Tx™ machine. However, since 2008, all lung SABR treatments at VUMC have been provided by using Varian's RapidArc® technology, many on the TrueBeam system. Professor Ben Slotman, VUMC's head of radiation oncology says that the biggest benefit of RapidArc for lung patients are shorter treatment times with less risk of motion.

He says:

"This is especially important for SABR, where high doses are delivered over fewer treatment sessions. The delivery of the highest dose for lung tumors was reduced from 30 minutes to just six minutes. With the introduction of TrueBeam technology, the integration between imaging and treatment delivery has been improved. By using the High Intensity Mode in the very near future, we expect to reduce the treatment time to less than three minutes."

Study leader, Professor Suresh Senan, radiation oncologist at VUMC, explained:

"SABR was first used in the Netherlands at VUMC in 2003, so we used the Dutch National Cancer Registry to examine survival data for three defined periods -- the three-year period before it was introduced, the three-year period while it was becoming available at other Dutch centers, and the three years when it was available nationwide. We noted a marked improvement in survival among the nearly 5,000 lung cancer patients aged over 75 who were treated over these nine years."

During the retrospective study period, advanced techniques like SABR resulted in an increase of radiotherapy use for lung cancer patients from 31 to almost 38%, whilst the rate of survival increased in almost 10 months from 16.8 to 26.1 months.

SABR Ups Survival in Early Lung Cancer (Video Medical And Professional 2018).

Section Issues On Medicine: Disease