Cranial irradiation cut incidence of brain metastases in locally advanced NSCLC

Prophylactic cranial irradiation did not improve survival for patients with locally advanced non–small cell lung cancer, but researchers found the procedure reduced the risk for brain metastases by more than half.

Alexander Sun, MD, a staff radiation oncologist with Princess Margaret Hospital/University Health Network in Toronto, discussed preliminary results for RTOG 0214 Monday at the 13th World Conference on Lung Cancer in San Francisco.

The researchers recruited 356 patients who had been successfully treated for locally advanced NSCLC and randomly assigned 163 to prophylactic cranial irradiation and 177 to observation.

Only 7.7% of patients in the irradiation group experienced brain metastases compared with 18.0% in the control group (HR=2.35; 95% CI, 1.29-4.30).

“Prophylactic cranial irradiation significantly decreased the incidence of brain metastases in patients with stage IIIa and IIIb NSCLC,” Sun said.

One-year OS was 75.6% in the irradiation group and 76.9% in the control group (HR=1.03; 95% CI, 0.77-1.36). Similarly, there were no significant differences in quality of life or neurocognitive function. Sun added there was no significant difference in one-year disease-free survival between the two groups, but said the trend favored the irradiation group (56.4% vs. 51.2%).

“There will be continued follow-up,” he said. “These are the preliminary results at the one-year point. With further follow-up, we’re hoping that some further differences may come out.”

For more information:
Sun A. #C6.6. Presented at: 13th World Conference on Lung Cancer; July 31-Aug. 4, 2009; San Francisco.