Local Control and Survival Following Concomitant Chemoradiotherapy in Inoperable Stage I Non-Small-Cell Lung Cancer

Journal Article · Sat Aug 01 04:00:00 EDT 2009 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/j.ijrobp.2008.10.067· OSTI ID:21276932

Campeau, Marie-Pierre ^[1]; Herschtal, Alan ^[2]; Wheeler, Greg; Mac Manus, Michael; Wirth, Andrew ^[1]; Michael, Michael ^[3]; Hogg, Annette; Drummond, Elizabeth ^[4]; Ball, David ^[1]

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1. Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria (Australia)
2. Centre for Biostatistics and Clinical Trials, Peter MacCallum Cancer Centre, Melbourne, Victoria (Australia)
3. Department of Haematology and Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria (Australia)
4. Department of Metabolic Imaging, Peter MacCallum Cancer Centre, Melbourne, Victoria (Australia)

Purpose: Concomitant chemoradiotherapy (CRT) increases survival rates compared with radical radiotherapy alone (RT) in Stage III non-small-cell lung cancer (NSCLC), as a result of improved local control. The effect of CRT on local control in Stage I NSCLC is less well documented. We retrospectively reviewed local control and survival following CRT or RT for inoperable Stage I NSCLC patients. Methods and materials: Eligible patients had histologically/cytologically proved inoperable Stage I NSCLC and had undergone complete staging investigations including an F-18 fluorodeoxyglucose positron emission tomography (FDG-PET) scan. Radiotherapy was planned as (1) 60 Gy in 30 fractions over 6 weeks with or without concomitant chemotherapy or (2) 50-55 Gy in 20 fractions without chemotherapy. Results: Between 2000 and 2005, 73 patients met the eligibility criteria and were treated as follows: CRT (60 Gy)-39; RT (60 Gy)-23; RT (50-55 Gy)-11. The median follow-up time for all patients was 18 months (range, 1-81 months). Survival analysis was based on intent to treat. Local progression-free survival (PFS) at 2 years was 66% with CRT and 55% with RT. The 2-year distant PFS was 60% following CRT and 63% after RT. The 2-year PFS rates were 57% and 50%, respectively. The 2-year survival rate for patients treated with CRT was 57% and 33% in patients receiving RT. Conclusions: Despite the use of CRT and routine staging with FDG-PET, both local and distant recurrences remain important causes of treatment failure in patients with inoperable stage I NSCLC.

• OSTI ID: 21276932
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Journal Name: International Journal of Radiation Oncology, Biology and Physics Journal Issue: 5 Vol. 74; ISSN IOBPD3; ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
CHEMOTHERAPY
COMBINED THERAPY
FLUORINE 18
FLUORODEOXYGLUCOSE
LUNGS
NEOPLASMS
PATIENTS
POSITRON COMPUTED TOMOGRAPHY
RADIOTHERAPY