Radiation twice a day, or a higher dose daily?

Upstate-led research outlines options for lung cancer patients

BY JEANNE ALBANESE

Aclinical trial led by Upstate radiation oncologist Jeffrey Bogart, MD, may have major implications for the treatment of small cell lung cancers.

Patients in Bogart’s trial had similar outcomes and long-term survival rates regardless of whether they were treated with once-a-day or twice-a-day radiotherapy.

With more than 700 participants, the trial was the largest ever performed in limited-stage small cell lung cancer. Data was collected from 2008 to 2019 from patients at Upstate and other cancer centers throughout the United States. Results were published in the Journal of Clinical Oncology, which Bogart describes as “a well-regarded high impact oncology publication.”

A twice-a-day regime had been the standard recommendation for patients with limited-stage small cell lung cancer, but many patients have trouble coming to the hospital for radiotherapy two times a day for three weeks. Only 15 percent of patients nationwide opt for twice-daily treatments, instead choosing a higher dose of radiation given once a day over seven weeks, not knowing whether it will be as effective.

Bogart’s trial showed no statistical difference in survival rates and outcomes.

Now that patients and doctors know both regimens can be associated with good outcomes, he says they have a real choice, “understanding that there may be some differences in side effects or their ability to complete the longer therapy.”

The next step in assessing the benefit of this treatment protocol is to look at subpopulations, for example, based on gender or age, says Bogart, who is a professor and chair of radiation oncology.

“The goal over time is to get away from the one-size-fits-all approach to offer better, more personalized therapy. The findings of this study move us in that direction.” u

Patients with small cell lung cancer (lower left) who came for radiation treatment (above) once daily were shown to have similar outcomes to those coming twice daily. Twice daily is difficult for many patients.

ABOUT 30,000 PEOPLE ARE DIAGNOSED WITH SMALL CELL LUNG CANCER EACH YEAR. THAT TYPE OF CANCER, WHICH IS TREATED WITH CHEMOTHERAPY AND RADIATION, ACCOUNTS FOR ABOUT 15 TO 20 PERCENT OF ALL LUNG CANCER PATIENTS, SAYS JEFFREY BOGART, MD, WHO CHAIRS UPSTATE’S DEPARTMENT OF RADIATION ONCOLOGY.

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