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New radiation therapy techniques boost early stage lung cancer survival rates: ASTRO

by Thomas Dworetzky, Contributing Reporter | September 27, 2016
Rad Oncology Radiation Therapy
Using stereotactic body radiation therapy (SBRT) to treat stage I non-small-cell lung cancer (NSCLC) has a “clear positive impact,” on patient outcomes, according to a new study presented at ASTRO analyzing Veteran’s Affairs Central Cancer Registry data.

“Lung cancer causes more than one million deaths each year worldwide,” Dr. Matthew Boyer, lead author of the study and a resident in radiation oncology at Duke University in Durham, N.C., told the audience at the 58th annual ASTRO meeting in Boston. “Moreover, an increasing number of localized, or stage I, lung cancer diagnoses are occurring, due to an aging population and advanced screening techniques.”

The study included participants' records from 2001 to 2010. Those in the analysis had an average age of 72, were almost all male, and 89.4 percent of whom were former or current smokers when diagnosed. About half had stage IA NSCLC. Another 41.5 percent had squamous cell carcinoma.
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At four years follow-up, “both overall and lung cancer specific survival rates were significantly higher for SBRT patients than for conventional radiation therapy (CRT) patients.”

“It is very rare for a study to show that double the number of patients were likely to be alive at four years due to the introduction of a new treatment,” said Dr. Boyer. “We identified that this doubling was due to the introduction of these advanced radiation techniques collectively termed stereotactic body radiation therapy, or SBRT. These findings of improved survival in stage I lung cancer patients in general, and those undergoing radiation specifically, are generalizable to patients outside the VHA. Although a number of studies are underway to define the best treatment for stage I non-small cell lung cancer, our study, and others, indicate that advances in radiation treatment and delivery can improve patient survival and that SBRT should be the standard treatment for patients treated with radiation for stage I NSCLC.”

These positive findings in treating early stage lung cancer underscore the importance of early detection and screening. This is especially noteworthy as CMS recently proposed a “drastic” cut to reimbursement for screening, as HCB News reported recently.

The new ruling calls for a 64 percent cut for decision-making sessions between doctor and patient about smoking, and a 44 percent cut to coverage of LDCT scans.

The proposal prompted a letter by groups objecting to the reimbursement plan, spearheaded by the Lung Cancer Alliance, the Prevent Cancer Foundation, the Society of Thoracic Surgeons, the American College of Radiology, and the Medical Imaging and Technology Alliance.

“Without access to LDCT scans, most lung cancers are not diagnosed until it is too late. Lung cancer screening provides critical early detection that saves lives — but the best test in the world won’t be effective if patients can’t gain access to it in their communities,” said Carolyn Aldigé, president and founder of the Prevent Cancer Foundation.

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