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Patients treated with locally advanced non-small cell lung cancer who receive chemotherapy and proton beam radiation therapy have fewer instances of a serious side effect called bone marrow toxicity than patients who receive chemotherapy and another type of radiation called intensity modulated radiation therapy (IMRT or standard x-ray radiation).
The new study was released at a symposium of the American Society for Therapeutic Radiology and Oncology (ASTRO) and conducted by M.D. Anderson Cancer Center in Houston. Anderson examined 142 patients with locally advanced non-small cell lung cancer. Of those, 75 patients received chemo plus a type of targeted photon (x-ray radiation) therapy called IMRT. The remaining 67 patients received chemo and proton beam radiation therapy.
“Because proton therapy allows us to control the radiation differently than other types of external beam radiation therapy, we were hopeful that we could keep radiation away from critical structures, like the bones to avoid bone marrow toxicity, “ said Dr. Ritsuko Komaki, a radiation oncologist at M.D. Anderson. After a follow-up time of 17 months, researchers found patients who received proton therapy with chemotherapy had a significant reduction in bone marrow toxicity compared to patients who received IMRT and chemotherapy. These findings suggest that using proton therapy over other types of radiation may allow doctors to give higher doses of radiation without compromising the chemo schedule to the lung tumor while avoiding some debilitating side effects, like bone marrow toxicity.
“These results are very promising for people with locally advanced lung cancer,” said Dr. Komaki. “However, we need to confirm these findings with a randomized trial.”
“This study suggests that proton beam therapy may benefit patients who are extremely vulnerable to bone marrow toxicity, “ noted Dr. James Cox, professor and head of radiation oncology at M.D. Anderson and the study’s senior author.
Anderson and Massachusetts General Hospital are currently working to enroll patients in an NCI-approved randomized prospective clinical trial to confirm these findings.
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