Combining chemotherapy, radiation and surgery tripled the survival of stage III lung cancer patients to 45 percent, say St. Joseph Medical Center doctors, who hope to replicate their success nationwide.
Fighting the cancer with weekly doses of chemotherapy and daily radiation can shrink cancerous tissue to levels that make surgery feasible, said Dr. Mark Krasna, thoracic surgeon and medical director of the Cancer Institute at St. Joseph in Towson.
Combining four successive studies of lung cancer patients, about 120 from the University of Maryland Medical Center and St. Joseph, Krasna said doctors found survival increased 30 to 50 percent, with a a 45 percent survival rate after five years. The compares with an average survival rate of 15 percent nationwide.
Stage III lung cancer typically has invaded the lymph nodes in the chest, complicating surgery, he said. “Historically, if people had lung cancer with lymph node invasion, they would not be candidates for surgery,” Krasna said. “Surgery is risky and that tends to outweigh the benefits.”
Krasna and colleague Dr. Ziv Gamliel, head of thoracic surgery at St. Joseph, are participating in a nationwide study by the Radiation Therapy Oncology Group to see if their results can be replicated in other hospitals.
Stage III lung cancer accounts for a huge population of patients because earlier stages are rarely caught, Gamliel said. “Until recently,” he said, “the likelihood of a cure was low.”
The National Institutes of Health estimates 213,380 new cases of lung cancer will be diagnosed by the end of this year, with 160,390 people expected to die from the disease.
Stage I has a 75 to 90 percent cure rate, measured by survival of five years or more, St. Joseph doctors say. Stage II has a 50 to 60 percent cure rate with surgery followed by chemotherapy, but doctors rarely diagnose lung cancers at these earlier stages.
Operating after radiation treatment is technically challenging because of scar tissue and inflammation, Krasna said. “Thanks to advances in surgical and radiation techniques,” he said, “we can now operate on these patients.”
