`Post-surgery radiotherapy for lung cancer harmful'
LONDON: The common practice of exposing lung cancer patients to radiation therapy after surgery may do more harm than good and should not be used routinely, a study published on Friday said.
Many lung cancer patients undergo radiation therapy after surgery to treat any remaining cancer cells. But the results of previous studies examining the effectiveness of the treatment have been contradictory or inconclusive.
In the largest study of its kind, an international team of researchers combined information gathered over the past 30 years in nine studies, involving 2,128 lung cancer patients worldwide.
Patients who had been treated with radiation therapy after surgery were 21 per cent more likely to die than those who only had surgery, the study published in this week's issue of The Lancet, a British medical journal, said. Researchers are unsure why radiation therapy caused more deaths earlier.
Nearly 900,000 people worldwide are diagnosed with lung cancer every year, a World Health Organisation report said.
Dr Gordon McVie, director- general at the Cancer Research Campaign in London and a lung cancer specialist who was not part of the study, said the research was authoritative and important.
``It should be compulsory reading for chief executives of hospitals. In many parts, this is routine treatment. It has been assumed that it was a good idea,'' he said. ``I was unsurprised that radiotherapy didn't prolong survival, but what I'm really concerned about is that it could actually do harm. There is a very clear message here.''
The patients in the study had non-small-cell lung cancer, which accounts for 80 per cent of all lung cancer cases. As many as 1,056 had surgery and radiotherapy while 1,072 had surgery alone.
The detrimental effect was worst in patients in the early stages of the disease, the study said. In those with more advanced but still operable lung cancer, the study said radiation therapy did not seem to cause harm although it also did not appear to help.
``The 21 per cent relative increase in the risk of death associated with radiotherapy, equivalent to an overall reduction in survival from 55 per cent (for surgery alone) to 48 per cent (for surgery and radiotherapy) at two years, represents a substantial hazard to these patients,'' said Lesley Stewart of the Medical Research Council, which led the study.
Researchers concluded that ``radiation therapy should not be given routinely to patients in the early stage of non-small-cell lung cancer and that its role in the treatment of more advanced stages of the disease is not clear and may warrant further research.''
``There was some hint that it might prevent recurring tumours, but that was heavily outweighed by the ill effects - the increased deaths,'' Mr Stewart said.
In an independent commentary, also published in The Lancet, Dr Alistair Munro of Ninewells hospital in Dundee, Scotland, said post-operative radiotherapy doses are ``too high and that there are valuable lessons to be learned'' from the Cambridge study.(AP)