Combined radiotherapy and chemotherapy modalities in the treatment of lung cancer
Abstract
The aim of combined modality treatment of lung cancer is to improve control of both local and metastatic disease. Retrospective reviews of the combined RT and CT modality in limited-stage small cell lung cancer (SCLC) showed an improvement of median survival and long term survival compared with CT alone. Among reports of 7 prospective trials in which patients were randomized so as to receive CT alone or CT with chest irradiation, combined modality treatment significantly increased the CR rate in 3/3, and the overall survival was significantly prolonged in 3/7. Concurrently combined modality treatment has a modest survival benefit in limited stage SCLC. Our phase 2 study combining RT with cisplatin-containing CT showed better improvement of response and survival than CT alone in non-small cell lung cancer (NSCLC). Four reports of prospective randomized studies have been performed to determine whether combined RT and combination chemotherapy might be better than RT alone in limited-stage NSCLC. Two of these studies demonstrated a survival and response advantage for the combined modality treatment. However, this approach for NSCLC reported so far has been disappointing, because of relative lack of effectiveness of the present CT.
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Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design.
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