Synchronous chemoradiation for squamous carcinomas

BMJ 2001; 323 doi: https://doi.org/10.1136/bmj.323.7310.453 (Published 25 August 2001) Cite this as: BMJ 2001;323:453

This treatment is not gold standard for lung cancer

  1. Fergus Macbeth, consultant oncologist (fergus.macbeth@velindre-tr.wales.nhs.uk),
  2. Michele Saunders, professor of clinical oncology
  1. Velindre Hospital, Cardiff CF14 2TL
  2. Research Wing, Mount Vernon Hospital, Northwood, Middlesex HA6 2RN
  3. Vancouver Island Cancer Centre and University of Victoria, Victoria, British Columbia, Canada V8R 6V5
  4. Department of Surgery, Greater Victoria Hospital Society, Victoria, British Columbia, Canada V8R 1J8

    EDITOR—Tobias and Ball's comments on the management of lung cancer in their editorial on synchronous chemoradiation for squamous carcinomas were disappointingly brief and unhelpful.1 Although some randomised trials have shown survival benefit from synchronous chemoradiation for patients with stage III non-small cell lung cancer, this is at the expense of increased toxicity. In a recent review of studies for non-small cell lung cancer by the Radiation Therapy Oncology Group Byhardt suggested that the “survival gains observed with some regimens may be negated by time spent with toxicity.”2 This is an important issue to which Tobias and Ball make no reference.

    The authors also say that continuous hyperfractionated accelerated radiation therapy (CHART)—an effective and relatively non-toxic treatment preferred by patients—has “proved logistically too difficult for most departments”; they postulate that …

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