Post-operative Radiotherapy for Lung Cancer

(RESCUE Trial)

This trial tests whether adding radiotherapy (a type of cancer treatment using radiation) after lung cancer surgery can help patients with stage III non-small cell lung cancer (NSCLC) live longer without cancer recurrence. It targets those who still have some cancer remaining after receiving a combination of chemotherapy and immunotherapy before surgery. The trial compares outcomes between patients who receive radiotherapy and those who do not. Ideal participants have undergone lung cancer surgery, still have cancer in their lymph nodes, and have not previously received chest radiotherapy. As a Phase 2 trial, it measures the treatment's effectiveness in an initial, smaller group of people.

The trial information does not specify whether you need to stop taking your current medications. It's best to discuss this with the trial coordinators or your doctor.

Research shows that post-operative radiotherapy (PORT) is usually manageable for patients. Studies have found that many patients experience side effects that can be controlled. Although some studies did not find that PORT significantly improves survival rates for lung cancer, they also did not identify major safety issues.

For instance, one study involving patients with non-small cell lung cancer (NSCLC) found no significant difference in safety between those who received PORT and those who did not. This indicates that the treatment does not greatly increase the risk of serious side effects. However, like any treatment, some patients might experience mild or moderate side effects, such as fatigue or skin irritation.

Researchers are excited about post-operative radiotherapy for lung cancer because it specifically targets the mediastinal area with a focused dose of 40 Gy in 15 fractions. Unlike standard care, which often involves a broader approach with systemic therapies or different radiotherapy protocols, this method may provide more precise treatment after surgery. The excitement lies in the potential for enhanced effectiveness in reducing cancer recurrence rates with fewer side effects by concentrating on the area most at risk post-surgery.

Research has shown that postoperative radiotherapy (PORT) can benefit some lung cancer patients. Specifically, for those with non-small cell lung cancer (NSCLC), PORT helps control the cancer locally, delays its progression, and improves overall survival in high-risk cases. In this trial, one group of participants will receive PORT, which has improved survival rates for patients with ypN2 NSCLC who have undergone chemotherapy and surgery. However, some studies suggest that PORT might not always enhance survival in NSCLC. It appears most helpful for patients with certain risk factors, such as when cancer cells remain after surgery. Another group in this trial will not receive PORT, allowing for a comparison of outcomes.²³⁶⁷⁸