Adding chest radiation to chemotherapy allows some people with small-cell lung cancer to live longer and cuts recurrence rates by nearly 50 percent, European researchers report.

The research was published in The Lancet to coincide with presentation at the annual meeting of the American Society for Radiation Oncology, held from Sept. 14 to 18 in San Francisco.

The study involved 498 adults undergoing chemotherapy at 42 facilities in the Netherlands, the United Kingdom, Norway, and Belgium. The patients were randomly assigned to two weeks of standard care with either radiation to the head alone or radiation to the head and chest.

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Although survival rates among the two groups of patients were similar during the first year, by the second year, 13 percent of patients who received head and chest radiation had survived, compared to 3 percent of those who received standard therapy.

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Six months after treatment, 7 percent of patients who underwent chest radiation did not experience a worsening of their condition, compared to 24 percent of those who received standard therapy. The researchers noted that 20 percent of patients who received chest radiation had a recurrence of cancer in their thorax, compared to 46 percent of those who only received head radiation.

“Thoracic radiotherapy in addition to prophylactic cranial irradiation should be considered for all patients with extensive stage small-cell lung cancer who respond to chemotherapy,” conclude the authors.


  1. Slotman, Ben J., MD, et al. “Use of thoracic radiotherapy for extensive stage small-cell lung cancer: a phase 3 randomised controlled trial.” The Lancet. doi:10.1016/S0140-6736(14)61085-0. September 14, 2014.