Esophagus-Sparing Radiation Technique Effective in Treating Locally Advanced Lung Cancer Patients

A study published in JAMA Oncology found that a contralateral esophagus-sparing technique reduces the risk of severe acute esophagitis in patients with locally advanced lung cancer treated with chemoradiation.

In a single-center phase 1 nonrandomized clinical trial, researchers assessed esophagitis rates in 25 participants with locally advanced non–small cell or small cell lung carcinoma treated with a combination of radiation therapy chemotherapy using a novel contralateral esophagus–sparing technique. The primary end point was defined as the rate of at least grade 3 acute esophagitis.

According to the results, among patients treated with the contralateral esophagus–sparing technique who had treatment breaks of 0 to 3 days (n=20), the rate of at least grade 3 esophagitis was 0%. Other toxic events the researchers observed among the cohort included 7 (28%) with grade 2 esophagitis, 3 (12%) with at least grade 2 pneumonitis (including 1 with grade 5), and 2 (8%) with at least grade 3 cardiac toxic event (including 1 with grade 5). There was no isolated local tumor failure. The 2-year progression-free survival rate was 57% (95% CI, 33%-75%), and the 2-year overall survival rate was 67% (95% CI, 45%-82%), the researchers noted.


“In 2014, when I was a radiation oncology resident, I noticed that patients did really, really well with our use of this sparing technique, and with Christine C. Olsen, MD, co-principal investigator of the trial, we moved to test this concept on a formal clinical study,” says lead author Sophia C. Kamran, MD, now a staff radiation oncologist at the Cancer Center via a press release.

Dr. Kamran added that: “Our findings support emerging national guidelines, which are increasingly recognizing the importance of sparing the esophagus, although an effective method to do so has neither been formalized nor well defined until now. This is the first prospective trial reporting on the use of a formalized technique.”