A recent study is questioning a controversial radiation treatment for lung cancer, that may not benefit the life expectancy of a cancer patient.
The treatment, Postoperative radiotherapy (PORT), according to U.S. researchers, may not help increase the life span of elderly patients, said Reuters Health. PORT is believed to help minimize the likelihood of a tumor returning, but the treatment can cause heart and lung damage, which could negate possible benefits, especially in senior patients, noted Reuters Health.
The new study appears in the journal Cancer. And by using the Surveillance, Epidemiology, and End Results (SEER) registry linked to Medicare records, 1307 patients were identified who had stage III NSCLC with N2 lymph node involvement diagnosed between 1992 and 2005. Propensity scoring methods and instrumental variable analysis were used to compare the survival of patients who did and did not receive PORT after controlling for selection bias.
Of the 1300 patients, these patients are not typically treated with radiation; however, this group’s cancer spread to the lymph nodes in the chest, said Reuters Health—no agreement exists on how to handle this development and prior studies have resulted in mixed responses. Of the patients studied, about half—most were over the age of 70—had received radiation treatment.
“Thus, these patients may be exposed to the side effects and complications of PORT without a clear benefit,” lead researcher Dr. Juan Wisnivesky, of Mount Sinai School of Medicine in New York, told Reuters Health. The findings have added to the ongoing debate concerning treatments for geriatric patients, especially when those treatments have been tested in younger patients.
“The marginal benefit of the additional treatment gets smaller and smaller as patients get older,” said Dr. David J. Sher, a radiation expert at Rush University Medical Center in Chicago. Dr. Sher was not involved in the study, noted Reuters Health, which pointed out that side effects could more adversely affect the health of older patients and patients may not live to see good effects. “Their overall fitness generally doesn’t warrant postoperative radiotherapy,” Dr. Sher told Reuters Health. “It’s a fine balance.”
Although it is challenging to compare the factors involved in each patient’s treatment, Dr. Wisnivesky and colleagues said that they did endeavor to take into account patient characteristics, tumor size, surgery type, complications, and other potential differences, wrote Reuters Health. Regardless of how the data was analyzed, the team was unable to find a survival benefit with post surgery radiation treatment.
The therapy runs $10,000 – $15,000, said Dr. Sher, who did note that, “That being said, if it prevents the recurrence it also saves a lot of money later,” said Reuters Health. Dr. Benjamin Smith, of the University of Texas MD Anderson Cancer Center did point out that the type of patients recently studied typically receive a grim prognosis: 20-30 percent survival rates over five years, Reuters Health explained.
The study concluded that the potential effectiveness of PORT should be evaluated further in randomized controlled trials.