1054 A multivariate analysis of predictive factors for survival after concurrent chemoradiotherapy for stage III non small cell lung cancer

Abstract

From July 1989 to February 1994, 140 patients (pts) with inoperable stage III non-small-cell lung cancer (NSCLC) were treated with concurrent chemoradiotherapy. Median age was 64 years with a majority of males (93%), WHO status 1 (66.4%), and squamous cell subtype (72%). Clinical stage was IIIA (65.7%), IIIB (34.3%), N0–1 (20.8%), N2 (57.8%) or N3 (21.4%). Using standard fractionation, pts received thoracic radiotherapy (TRT) up to a median dose of 60 grays (n = 116), or 45 grays before planned surgery (n = 24). 73 pts received concurrent cisplatin at a dose of 20 mg/sqm/d over 5 days for two cycles during TRT. In addition, 67 pts subsequently received etoposide at a dose of 50 mg/sqm/d over 5 days, followed by two additional cycles of the same chemotherapy. With a median F/U of 41 months, overall survival was 60% and 33% at 1 and 2 years respectively. Univariate and multivariate analysis were performed with the aim of identifying characteristics that could predict 2-year survival. Age, sex, performance status and weight loss, as well as histologic subtype, histologic grade, tumor size, and T stage, had no significant predictive value. Difference in 2-year survival for clinical stage IIIA (38%) or IIIB (22.5%) did not reach statistical significance, neither did the degree of clinical nodal involvement (N0–N1 = 47.6%, N2 = 32.3%, N3 = 19.7%). Multivariate analysis identified three highly significant predictive factors with independant prognostic value: addition of etoposide (39.3%, P = .008), negative biopsy at the initial tumor site (50.6%, P P P