Thoracic Radiotherapy: breakthrough for survival in lung cancer

Small cell lung cancer (SCLC, also called oat cell cancer) is one of two main types of lung cancer and differs from non-small-cell lung cancer ( NSCLC) in the following ways:

  • SCLC grows rapidly, the time from development of symptoms to diagnosis is within 90 days or less. This type of cancer if often diagnosed in its advanced stages.
  • Spreads quickly, 67-75% of people who have SCLC will have spread the cancer outside of the lungs at the time of initial diagnosis


Small cell lung cancer represents 10-15% of all lung cancer cases. The chance of cancer recurrence remains high among people diagnosed with this specific type of cancer.

How is it treated?

Standard treatment for SCLC includes chemotherapy followed by prophylactic cranial radiotherapy which is radiation to the head and neck to prevent cancer from spreading to the brain.

Thoracic Radiotherapy, also known as chest radiation therapy, is not usually administered to SCLC patients since cancer has spread outside of the thorax most of the time.

The Study

A team of researchers from VU University Medical Center in Amsterdam and the Netherlands wanted to see the results of patient survival and cancer recurrence if thoracic radiotherapy was offered in combination with standard treatment for SCLC. Researchers conducted a clinical trial involving 498 adults with advanced SCLC from 42 different hospitals, 16 of the hospitals were in the Netherlands, 22 in the UK, 3 in Norway, and 1 in Belgium.

The 498 patients had already responded to chemotherapy and were randomly asssigned one of two treatments-prophylactic cranial radiotherapy alone or prophylactic crainial rediotherapy along with thoracic radiotherapy over a two week period. Patients were followed-up for an average of two years.


After the first year, patient survival was similar between both groups based on treatment options. On the other hand, 13 % of patients treated with prophylactic cranial radiotherapy plus thoracic radiotherapy were alive after 2 years. These results were compared to the 3% of patients who were alive after being treated with just prophylactic cranial radiotherapy alone after 2 years.

In addition, only 20% of patients who received prophylactic cranial radiotherapy plus thoracic radiotherapy had recurrence in the chest compared to 46% of patients who received prophylactic cranial radiotherapy alone.


Researchers discussed the benefits of using thoracic radiotherapy and concluded that the therapy would be easy to provide to patients at a low cost, even in radiotherapy departments who have limited resources.

The study was published in the Lancet, which can be viewed online to obtain more information on the experiment.

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