Concurrent Chemotherapy and Short Course Radiotherapy in Patients with Stage IIIA to IIIB Non-small Cell Lung Cancer Not Eligible for Radical Treatment: Results of a Randomized Phase II Study

Abstract

Upfront chemotherapy combined with palliative radiotherapy (30 Gy) is a promising treatment option in the subpopulation of patients with stage IIIA to IIIB NSCLC not amenable for definitive chemoradiotherapy and deserves further investigation.

Efficacy and safety of concurrent chemoradiotherapy in ECOG 2 patients with locally advanced non-small-cell lung cancer: a subgroup analysis of a randomized phase III trial

“…Secondly, except for PS of ECOG 2 and weight loss ≥5% (n = 27), our enrolled patients had no other poor prognostic factors. As a result, the prognosis of ECOG 2 patients in our study was more favorable than that of the poor risk patients enrolled in other clinical trials [13,14,17,18,20]. Thirdly, our CCRT intensity including RT dose and chemotherapy regimen was more aggressive than that administered for poor risk patients with palliative intent [17,18].…”

“…Based on the encouraging outcome achieved in the above single arm phase II trials, many clinical trials have investigated whether CCRT is superior to radiotherapy alone or chemotherapy alone for poor risk stage III NSCLC. Nawrocki et al [17] conducted a phase II study which randomly assigned poorrisk stage III NSCLC to either radiation alone of palliative dose (30Gy) or the same radiation dose delivered concurrently with the third of 3 cycles of cisplatin/vinorelbine. Three-dimensional conformal planning was used.…”

Concurrent palliative chemoradiation leads to survival and quality of life benefits in poor prognosis stage III non-small-cell lung cancer: a randomised trial by the Norwegian Lung Cancer Study Group

“…This regimen was well tolerated and yielded a median survival comparable to that of patients with better prognosis who received cisplatin-based chemoradiotherapy. In a recent randomised phase II study, Nawrocki et al (2010) concluded that upfront chemotherapy combined with palliative radiotherapy (30 Gy/10 fractions) resulted in superior response rates and survival when compared with radiotherapy alone in patients with stage III locally advanced NSCLC and poor prognostic factors (tumours >8 cm and/or poor pulmonary reserve, performance status 0–2, tumour-related chest symptoms).…”

Przeżycia chorych na niedrobnokomórkowego raka płuca leczonych napromienianiem w latach 2003–2006 w Samodzielnym Publicznym Zakładzie Opieki Zdrowotnej Ministerstwa Spraw Wewnętrznych z Warmińsko-Mazurskim Centrum Onkologii w Olsztynie

“…W latach 2003-2006 w SP ZOZ MSW z W-MCO w Olsztynie leczono napromienianiem 801 pacjentów chorych na NDRP. 81 pacjentów (10% wszystkich analizowanych) było leczonych w ramach randomizowanego badania klinicznego II fazy "Concurrent chemotherapy and short course radiotherapy in patients with stage IIIA to IIIB non-small cell lung cancer not eligible for radical treatment" [6] (tab. I).…”

“…Statystyczne porównanie tych grup jest więc niemożliwe. Wcześniej opublikowane wyniki badania z randomizacją przeprowadzonego w tutejszym ośrodku dla grupy chorych z rozpoznaniem NSCLC w stopniu zaawansowania klinicznego IIIA i IIIB niekwalifikujących się do leczenia radykalnego wykazały lepsze 2-letnie OS pacjentów poddanych paliatywnej jednoczasowej radiochemioterapii w stosunku do pacjentów poddanych samodzielnej radioterapii (10 frakcji w dawce frakcyjnej 3 Gy), odpowiednio 24% vs 6% [6]. Pięcioletnie przeżycia pacjentów, którzy otrzymali radiochemioterapię, wyniosły 9%.…”