A trial looking at the treatment of lung cancer which has spread to the brain (Quartz)

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Cancer type:

Cancer spread to the brain

Lung cancer

Non small cell lung cancer

Secondary cancers

Status:

Results

Phase:

Phase 3

This trial tried to find out which treatment combination gave the best quality of life for people with non small cell lung cancer that has spread to the brain. This is called secondary brain cancer.

Cancer Research UK supported this trial.

More about this trial

When lung cancer spreads to the brain, you are often offered advice and support. This is called optimal supportive care and usually includes treatment with steroids as well as other treatments to manage symptoms. You might also have a course of radiotherapy to the whole brain.

But although radiotherapy for secondary brain cancer can improve some symptoms, it does cause side effects. So doctors are not sure if radiotherapy to the whole brain is the best treatment in this situation.

In this trial people with non small cell lung cancer that had spread to the brain, had either:

optimal supportive care and steroid treatment
optimal supportive care, steroid treatment and radiotherapy to the whole brain

The aim of the trial was to find out which treatment was better for the patient’s quality of life.

Summary of results

The trial team found that there was little difference between having radiotherapy to the brain and optimal supportive care compared to having optimal supportive care only.

This was a phase 3 randomised study. 538 people took part. They were put into 1 of 2 treatment groups. Neither they nor their doctor could choose which group they were in.

269 people had optimal supportive care and steroid treatment
269 people had optimal supportive care, steroid treatment and radiotherapy to the whole brain

The dose of steroids was decided by someone’s symptoms and was adjusted if their symptoms changed, by their doctor or their specialist nurse. People having radiotherapy were given 5 daily treatments.

The most common side effects people having radiotherapy had included:

drowsiness
hair loss
feeling sick (nausea)
dry or itchy scalp

Everyone taking part completed a weekly questionnaire which looked at the symptoms and side effects they had and how this was affecting their day to day life. This is called quality of life. The trial team found little difference in the quality of life between having radiotherapy to the brain and optimal supportive care compared to having optimal supportive care only.

The trial team also looked at the number of people alive (overall survival) and they found little difference between the two groups. There was also no difference in steroid use between the two groups so having radiotherapy did not reduce the amount of steroids people needed.

The trial team concluded that there was little benefit for most people with secondary brain cancer in having radiotherapy compared to having optimal supportive care alone. However they think that younger people might have some benefit in having radiotherapy.

We have based this summary on information from the research team. The information they sent us has been reviewed by independent specialists (peer reviewed Open a glossary item ) and published in a medical journal. The figures we quote above were provided by the trial team who did the research. We have not analysed the data ourselves.