PHILADELPHIA - Treating the brain with a preventative course of radiation may help Small Cell Lung Cancer (SCLC) patients - whose tumors often spread to their brain -- live longer, according to a new study from researchers in the Abramson Cancer Center and Perelman School of Medicine at the University of Pennsylvania. A separate study revealed that the most commonly-targeted mutation of Non-Small Cell Lung Cancer (NSCLC) is most likely to result in progression at the primary site. Both projects will be presented this weekend at the 2017 Multidisciplinary Thoracic Cancers Symposium in San Francisco.
The first study (Oral Abstract Session, Presentation #11) deals with SCLC, which is a type of lung cancer with the strongest ties to smoking. It's particularly aggressive, with between 60 and 70 percent of patients diagnosed at advanced stages of the
disease. The disease will spread to the brain in more than half of the patients.
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Penn researchers looked into a treatment called Prophylactic Cranial Irradiation (PCI), which involves treating the brain with radiation before the cancer has spread there in hopes of preventing the disease's spread and prolonging survival.
"PCI is controversial for patients with extensive stage disease because two past randomized control trials have looked at this question but came to conflicting results," said the study's lead author Sonam Sharma, MD, chief resident of Radiation Oncology.
The group studied 944 propensity score matched patients in the National Cancer Database who had metastatic SCLC but whose disease had not spread to the brain, making this the largest study to ever examine the question of PCI.
They found PCI had a positive impact on survival. Among patients who survived at least six months, those who underwent the preventative brain radiation treatment lived an average of almost three months longer than those who did not receive PCI. Among patients who had a minimum overall survival of at least nine months, survival among patients receiving PCI was about two and a half months longer.
The data also shows certain patients were more likely to receive PCI than others. African Americans, patients 75 or older, and those with additional diseases were less likely to receive the treatment.
"Our study demonstrates that PCI has a significant impact on overall survival for patients with metastatic small cell lung cancer," Sharma said. "It also highlights existing healthcare disparities in potentially life prolonging therapies."
