Twice-daily radiation linked to better quality of life in lung cancer trial
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Previously, the primary endpoint results of the NRG-LU005 (NCT03811002) study assessing the addition of the immunotherapy drug atezolizumab (Tecentriq) to standard-of-care concurrent chemoradiation for limited-stage small-cell lung cancer were reported at the American Society for Radiation Oncology 2024 Annual Meeting. Those results showed that adding atezolizumab did not improve overall survival (OS) for this patient population.
At the same time, an exploratory analysis reported a longer median OS among patients who received twice-daily radiation, though the RT schedule was not randomized. As a follow-up to that study, a patient-reported outcomes (PRO) analysis explored the impact of the NRG-LU005 treatment regimens on quality of life (QOL). The results of this PRO analysis are now published in the Journal of Thoracic Oncology after previously being reported as a late-breaking abstract at the ASTRO 2025 Annual Meeting in San Francisco.
Although NRG-LU005 results did not meet the study's primary endpoint regarding OS, an incidental finding indicated that twice-daily radiation was associated with longer survival than once-daily radiation. While the study was not randomized between twice-daily and once-daily radiation, the NRG-LU005 PRO analysis also suggested less clinically meaningful decline in longer-term QOL with twice-daily radiation, compared with once-daily radiation, in a cohort of participants who completed PRO surveys.
NRG-LU005 accrued and randomized 544 patients receiving standard chemoradiation with thoracic RT (either at 45 Gy twice daily or 66 Gy daily) to receive or not receive concurrent and adjuvant immunotherapy. PROs included validated instruments: FACT-TOI, EQ-5D-5L and PROMIS-Fatigue. Clinically meaningful decline (CMD) and longitudinal trends were also evaluated.
Among a cohort of trial participants who were alive and on-study at each assessment, PRO compliance for this analysis was high—exceeding 85% at baseline and stabilizing at 60%–68% through 21 months after completion of chemoradiation. Healthier patients with better performance scores and lung function were more likely to complete these surveys. FACT-TOI declined in both arms during chemoradiation, as expected; however, it improved at 3 months and either remained stable or exceeded baseline by 6–21 months following treatment.
Fewer patients in the immunotherapy arm of NRG-LU005 experienced CMD (25% vs. 38%) in FACT-TOI at 21 months. However, this observation is influenced by the fact that those who completed the assessments tended to be healthier. Of note, while the study was not randomized between twice-daily and once-daily RT, approximately half of the patients received twice-daily radiation, which was associated with a more favorable QOL trajectory over time than once-daily radiation.
The association remained in multivariable analysis after adjusting for patient characteristics, but because the radiation schedule was not randomized, other factors may have contributed to the results. The QOL chair of this NRG-LU005 study was Dr. Benjamin Movsas, co-medical director of Henry Ford Cancer in Michigan and co-chair of the Henry Ford Health + Michigan State University Health Sciences Cancer Committee.
Publication details
Benjamin Movsas et al, Comprehensive Patient Reported Outcomes (PROs) from NRG Oncology/Alliance LU005: A Randomized Trial Of Chemoradiation +/- Atezolizumab In Limited-Stage Small Cell Lung Cancer, Journal of Thoracic Oncology (2026). DOI: 10.1016/j.jtho.2026.104117
Journal information: Journal of Thoracic Oncology
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Citation: Twice-daily radiation linked to better quality of life in lung cancer trial (2026, August 29) retrieved 29 August 2026 from https://medicalxpress.com/news/2026-08-daily-linked-quality-life-lung.html This document is subject to copyright. Apart from any fair dealing for the purpose of private study or research, no part may be reproduced without the written permission. The content is provided for information purposes only.