Jeffrey D. Bradley, MD, Professor, Radiation Oncology, Washington University School of Medicine in St. Louis, discusses ongoing research involving radiation therapy for lung cancer.

Beyond the phase III RTOG 0617 study, there are still important questions surrounding radiation treatment in non-small cell lung cancer and small cell lung cancer.

The randomized phase II RTOG 1106 study uses PET scans at mid-treatment to refocus the radiation. In the trial, researchers treat a smaller volume and increase the radiation dose. The number of treatments in the study is fixed at 30, Bradley says, so the last 10 treatments are given to a smaller volume at a higher dose per day (hypofractionated radiation treatment).

Bradley says he has also been working with the 10 U.S. institutions that have proton therapy to open a trial comparing it with IMRT. The trial will look at IMRT with x-rays versus proton therapy in patients with stage 3 lung cancer.

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Dr. Bradley on Radiation Therapy in Lung Cancer

Jeffrey D. Bradley, MD, Professor, Radiation Oncology, Washington University School of Medicine in St. Louis, discusses the background of the phase III RTOG 0617 study.

In the phase III randomized trial, patients with stage III non-small cell lung cancer were randomized to high-dose (74 Gy) or standard-dose (60 Gy) chemoradiotherapy with or without cetuximab. Patients were divided into four arms in a 2x2 factorial design.

The second randomization in this trial was for patients to be given cetuximab during and after radiation therapy. At the 2013 American Society of Clinical Oncology Meeting, Bradley presented on the first randomization -- the radiation dose question.

View more from the 2013 ASCO Annual Meeting

Dr. Bradley on the Background of the RTOG 0617 Study

Jeffrey D. Bradley, MD, S. Lee Kling, associate professor, Radiation Oncology, chief, Thoracic Service, director, S. Lee Kling Center for Proton Therapy, Washington University School of Medicine, believes it is an exciting time in lung cancer.

Stereotactic body radiation therapy (SBRT), also known as stereotactic ablative radiotherapy (SABR), is used to eradicate smaller lung cancers and other cancers as well. Groups have launched trials comparing SABR to illuminated lung resection.

Bradley expects a lot of changes will occur in stage I lung cancer. In systemic therapy the biology of lung cancer is beginning to be characterized which is resulting in multiple personalized therapies for a variety of different subtypes of lung cancer.

These topics, and more, were discussed at the 12th International Lung Cancer Congress and will continue to be discussed into the future.

Dr. Jeffrey Bradley from Washington University School of Medicine Discusses Key Lung Cancer Topics

Jeffrey D. Bradley, MD

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Dr. Bradley on Radiation Therapy in Lung Cancer

Dr. Bradley on the Background of the RTOG 0617 Study

Dr. Bradley Discusses Key Lung Cancer Topics