A recent investigation led by Feng-Ming (Spring) Kong, MD, PhD, Chair of the Department of Radiation Oncology and Co-Leader of the GRU Cancer Center Lung Cancer Disease-Site Working Group, studied the effect of high-dose radiation to the pulmonary artery on overall and median survival in 100 patients with inoperable/unresectable non-small cell lung cancer (NSCLC) treated with or without concurrent chemotherapy.
Although the standard of care for these patients may be optimized by increasing the dose of radiation therapy (RT), one risk is a potential increase in massive hemorrhage. It is possible that cancer itself can lead to hemorrhaging as it progresses to large blood vessels.
The current study sought to determine if targeting RT to the pulmonary artery (often invaded by cancer in patients with advanced NSCLC) would negatively affect 1-year and median survival. The research showed that neither maximum/mean RT doses to the pulmonary artery nor overall grade of pulmonary artery invasion significantly associated with overall survival. However, massive pulmonary artery invasion correlated with massive bleeding in a small number of cases. The study also suggests a cutoff value for pulmonary artery dose volume that is predictive of decreased overall survival.[Han CB, Wang WL, Quint L, Xue JX, Matuszak M, Ten Haken R, Kong FM. Pulmonary artery invasion, high-dose radiation, and overall survival in patients with non-small cell lung cancer. Int J Radiat Oncol Biol Phys. 2014 Jun 1;89(2):313-21.]