Phase II Trial Shows Single-Fraction SBRT Effective for Early-Stage Lung Cancer
A phase II clinical trial shows single-fraction stereotactic body radiation therapy with 30 Gy is as effective as three-fraction SBRT with 60 Gy for early-stage NSCLC. The study of 98 patients found no meaningful differences in survival, recurrence, or side effects between the two approaches. This could reduce costs and increase convenience for patients unable to undergo surgery.
Many people with lung cancer can be treated with a highly precise, high dose of radiation given in just one session without compromising the effectiveness of the treatment. The phase II clinical trial followed 98 patients with early-stage NSCLC whose tumors were located in the outer parts of the lung and who were not able to undergo surgery. Participants were randomly assigned to one of two approaches: three-fraction SBRT with 60 Gy delivered over three sessions, or single-fraction SBRT with 30 Gy delivered in one session.
Patients were monitored regularly for up to 5 years. The research team found no meaningful differences between the two groups in survival, cancer recurrence, or side effects. Data showed that reducing both the radiation dose and the number of treatment sessions resulted in the same long-term results as a higher dose delivered over more treatment sessions.
"This is an easy way to lower costs and increase convenience for patients without compromising on cancer control," said the lead author. "This approach may be even more important to those patients who must travel large distances to receive radiation."
The study authors concluded, "This randomized phase II study demonstrated that 30 Gy in one fraction was equivalent to 60 Gy in three fractions in terms of toxicity, local failure, freedom from distal failure, progression-free survival, and overall survival."
When patients with early-stage lung cancer cannot undergo surgery because of their age, condition, or other reasons, typically they are treated with stereotactic body radiation therapy (SBRT), which precisely targets tumors to avoid damaging healthy tissue nearby. The treatment strategy could offer multiple benefits for many patients who cannot undergo lung cancer surgery, including fewer side effects from radiation exposure, less disruption to their lives and, possibly, lower medical costs.