Randomized trial shows limited clinical benefit for patients with NSCLC and brain metastases
TUESDAY, Sept. 6, 2016 (HealthDay News) — Whole brain radiotherapy (WBRT) seems to offer limited clinical benefit for patients with non-small-cell lung cancer with metastases, according to a study published online Sept. 4 in The Lancet.
Paula Mulvenna, M.B.B.S., from Newcastle Hospitals NHS Foundation Trust in the United Kingdom, and colleagues conducted a non-inferiority phase 3 randomized trial (The Quality of Life after Treatment for Brain Metastases) at 69 U.K. and three Australian centers. A total of 538 patients with non-small-cell lung cancer with brain metastases were randomized to either optimal supportive care (OSC; oral dexamethasone) plus WBRT (269 patients) or OSC alone (269 patients).
The researchers found that patients reported significantly more episodes of drowsiness, hair loss, nausea, and dry or itchy scalp while receiving WBRT, although there was no evidence of a difference in the rate of serious adverse events between the groups. No between-group differences were seen in overall survival (hazard ratio, 1.06; 95 percent confidence interval, 0.90 to 1.26), overall quality of life, or dexamethasone use. The difference between the mean quality-adjusted life-years was 4.7 days.
“Although the primary outcome measure result includes the prespecified non-inferiority margin, the combination of the small difference in quality-adjusted life-years and the absence of a difference in survival and quality of life between the two groups suggests that WBRT provides little additional clinically significant benefit for this patient group,” the authors write.
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