FDG-PET Distinguishes Low- and High-Risk Lung Cancer Patients After Radiotherapy

Fluorodeoxyglucose-positron emission tomography (FDG-PET) scans may be able to detect early-stage non-small cell lung cancer (NSCLC) patients who are at high risk of treatment failure after stereotactic body radiation therapy (SBRT). A retrospective study examined patients with early-stage NSCLC who were ineligible for or refused surgery and were instead treated with SBRT. Patients with lower FDG-PET readings prior to SBRT treatment survived longer, and those whose FDG-PET readings changed more after SBRT were less likely to experience treatment failure. FDG-PET scans may therefore help identify which patients are at lower or higher risk of recurrence; high-risk patients may opt for additional treatment and/or more frequent surveillance after treatment. FDG-PET has shown similar predictive value in early-stage NSCLC treated with surgery.

Stereotactic Ablative Radiotherapy May Be Effective Option in Multiple Primary Lung Cancer

A significant number of lung cancer patients develop more than one primary tumor. The tumors arise independently and are not cases of one original tumor spreading to other sites or recurring after removal. This condition, known as multiple primary lung cancer (MPLC), is often treated surgically. However, not all patients are eligible for surgery. A recent study retroactively examined the records of patients with early-stage MPLC who had been treated with stereotactic ablative radiotherapy (SABR), a form of radiotherapy that uses high radiation doses over relatively few sessions, instead of surgery. Patients experienced good tumor control rates, and almost half survived for 4 years or more. SABR may be an effective treatment option for patients with inoperable MPLC.

Stereotactic Body Radiation Therapy Is Safe and Effective in Early-Stage Lung Cancer

Stereotactic body radiation therapy (SBRT), a type of radiotherapy that uses high doses of radiation given over a comparatively small number of sessions, is the treatment of choice for patients with stage I non-small cell lung cancer (NSCLC) who cannot undergo surgery because of other medical problems. However, until now the use of SBRT for these patients was based on limited evidence. A systematic study spanning several institutes found that SBRT (sometimes also called stereotactic ablative radiotherapy or SABR) for stage I NSCLC was safe and effective. Higher radiation doses were associated with better outcomes.

Analysis Highlights Most Cost-Effective Treatments for Early-Stage Lung Cancer

Researchers have constructed a model to assess the cost-effectiveness of different treatments for stage I non-small cell lung cancer (NSCLC) based on treatment costs, predicted life expectancy, and expected quality of life. Model simulations indicate that lobectomy (removal of an entire subsection of the lungs) is the most cost-effective treatment for patients whose cancer is clearly operable. For patients who are only borderline eligible for surgery due to poor health (‘marginally operable’), who often cannot withstand lobectomy, a type of radiotherapy called stereotactic body radiation therapy (SBRT), also known as stereotactic ablative radiotherapy (SABR), was found to be more cost-effective than wedge resection (removal of a small piece of lung containing the cancer).

Reduced-Duration, High-Intensity Radiation Therapy Appears Safe and Effective for NSCLC

A recent study found stereotactic ablative radiotherapy (SABR) to be safe and effective for non-small cell lung cancer (NSCLC) treatment, offering better tumor control, lower toxicity, and greater convenience than conventional radiation therapy. The retrospective study focused on patients with NSCLC who could not be treated with surgery. Outcomes were especially beneficial for tumors that were smaller and had lower metabolism (measured by sugar absorption rate). SABR, also called stereotactic body radiation therapy (SBRT), uses higher doses of radiation over a smaller number of sessions compared to conventional radiation therapy.

Doubts Incite Conflict over Prostate Cancer Vaccine Provenge

Results of a clinical trial that evaluated the prostate cancer vaccine Provenge have come under scrutiny. Questions arise regarding the reported 4-month survival benefit that ultimately led to FDA approval. Disputers suggest that a flaw in methods led to the survival benefit, but that the vaccine may actually cause harm.

Study Finds Surgery for Early Prostate Cancer Unecessary

A recent study evaluated the usefulness of surgery versus observation to treat localized prostate cancer. In the study, 731 men were followed for 10 years. Those treated with surgery did not have a significant decreased risk of death compared to those who were observed for advancing cancer.

Primary source: http://www.nejm.org/doi/full/10.1056/NEJMoa1113162?query=featured_home

Yearly Prostate Cancer Screening May Decrease Quality of Life

A recent study weighed the benefits of yearly prostate cancer screening, finding that the potential disadvantages decrease the potential advantages by 23%. Harmful results of yearly prostate screening include negative prostate biopsies, radical prostatectomy, and radiation therapy.

Prostate Cancer Gene May Determine Tumor Growth, Return

A recent study found a relationship between the SPARCL1 gene and prostate cancer recurrence. Individuals who had lower activity of the gene had a higher risk of prostate cancer recurrence over 10 years. A test to detect SPARCL1 is being designed.

Primary source: http://www.pnas.org/content/109/37/14977.full.pdf+html