Prophylactic Brain Radiation May Be Beneficial for Non-Small Cell Lung Cancer Patients
Interestingly, I asked my wife's radiation onc what he thought about doing this prior to her starting adjuvant radiation and he said that he wouldn't be surprised if it was done eventually, but wouldn't be accepted now.
According to a recent article published in the Journal of Clinical Oncology, radiation to the brain in patients diagnosed with stage IIIA non-small cell lung cancer may help to prevent brain metastasis.
Lung cancer remains the leading cause of cancer-related deaths in the United States and Europe. Stage IIIA non-small cell lung cancer (NSCLC) is a single cancer mass that is not invading any adjacent organs and involves one or more lymph nodes away from the primary cancer. Stage IIIA cancers are further subdivided into N1 and N2 subgroups. N1 cancers involve lymph nodes farther away from the mediastinum, the middle section of the chest cavity, and are easier to remove with surgery. N2 cancers involve lymph nodes in the mediastinum and may be difficult to remove surgically.
Although patients with stage IIIA NSCLC may initially respond to standard therapeutic approaches, cancer recurrences occur frequently. It is often these recurrences that are the cause of death. One common area of the spread of NSCLC is the brain. Researchers are evaluating ways in which to prevent the spread of cancer to specific sites in the body, including radiation to the brain as part of initial therapy.
Researchers from the Dana-Farber/Brigham and Women's Cancer Center and the Beth Israel Deaconess Medical Center in Massachusetts recently reviewed data from patients diagnosed with stage IIIA N2 NSCLC. The study included 177 patients who were treated between 1988 and 2000. The average duration of survival from the time of surgery was 21 months, with 34% of patients surviving 3 years. The brain was the most common site of cancer recurrence, with 34% of patients developing brain metastasis as their first site of recurrence, and 40% of all patients developing brain metastasis overall. Patients with specific cellular types of NSCLC referred to as nonsquamous, and those whose cancer was still present in lymph nodes following preoperative therapy had a 53% rate of developing brain metastases within 3 years.
The researchers concluded that brain metastasis is the most common site of cancer spread in patients diagnosed with stage IIIA N2 NSCLC. They state that patients with this diagnosis may benefit from prophylactic radiation to the brain during initial therapy regimens. Patients with stage III N2 NSCLC may wish to speak with their physician about their individual risks and benefits of prophylactic radiation to the brain.
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