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Back To Vidyya Post-Surgical Chemotherapy Adds No Benefit In Lung Cancer

Findings Appear In The 26 October Issue Of The New England Journal Of Medicine

Adding chemotherapy to radiation therapy does not prolong survival in operable, non-small-cell lung cancer, according to a large, randomized study that compared the chemotherapy/radiation combination to radiation alone. The new findings appear in the Oct. 26 issue of the New England Journal of Medicine.

Led by Steven Keller at Beth Israel Medical Center in New York, the trial enrolled 488 patients whose disease had spread to, but not beyond, nearby lymph nodes. All had undergone surgery in which any visible tumor was completely removed. The patients were divided into two groups: One group received the chemotherapy drugs cisplatin and etoposide concurrently with radiation therapy, while the other received radiation alone.

Patients receiving the combined treatment had a median survival of 38 months compared to 39 months among those receiving radiation alone. Overall survival and recurrence rates were also similar in the two groups.

The study is the latest of many that have looked at post-surgical, or adjuvant, chemotherapy in non-small-cell lung cancer, according to an accompanying editorial by Desmond N. Carney, M.D., at Mater Hospital in Dublin, Ireland, and Heine H. Hansen of the Finsen Center in Copenhagen, Denmark. They say that most of these trials have shown no benefit with chemotherapy and conclude that adjuvant chemotherapy in patients with tumors that have been completely removed "should not be considered standard care."

However, other and newer kinds of presurgical and post-surgical chemotherapy are now in clinical trials and may prove to be of benefit. Participation in these trials remains an important option for patients and "should be encouraged," say Carney and Hansen, "so that real progress can be made against non-small-cell lung cancer."

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Editor: Susan K. Boyer, RN
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