New boost found for lung cancer treatment

Chemotherapy following surgery to remove early lung cancer prolongs patients' lives by almost two years on average, according to a study in today's New England Journal of Medicine.

Patients traditionally were monitored for new tumors without drug treatment, as the toxic side effects of chemotherapy were thought to outweigh the benefits. The study found that patients taking two generic drugs lived almost eight years on average, compared with six for those without, at the expense of nausea, fatigue, vomiting, diarrhea, and low white-cell counts.

The results should alter treatment for early-stage patients with lung cancer, researchers said. Lung cancer kills more than 160,000 people annually and is the leading cause of cancer death in the United States. About half of those with early-stage disease survive at least five years.

The findings were presented at the American Society of Clinical Oncology meeting in New Orleans last year.

Chemotherapy ''can be safely administered in the outpatient setting with limited toxicity and is beneficial in non-small-cell lung cancer," said researchers led by Timothy Winton, an oncologist at the National Cancer Institute of Canada in Kingston, Ontario. ''We believe that a brief course of such chemotherapy should become the standard of care for patients."

Most of the side effects, including low levels of infection-fighting white blood cells, were resolved in about three months, the study of 482 patients in North America showed.

Two people died from the toxic side effects of treatment using vinorelbine plus cisplatin, the researchers said.

The findings were astonishing and should have immediate implications for the treatment of patients with non-small-cell lung cancer, the most common form of the disease that affects 1.35 million people worldwide each year, wrote Katherine M.W. Pisters, an oncologist and specialist in lung cancer at the M.D. Anderson Cancer Center at the University of Texas in Houston.

''The controversy surrounding adjuvant chemotherapy for respectable non-small-cell lung cancer is over," she wrote in an editorial accompanying the study. Chemotherapy ''should be recommended" after tumor removal, she wrote.

''Additional research will enable us to select those patients most likely to benefit," lessen the toxicity, and identify more effective combination, Pisters wrote.