A prospective phase II study of consolidation chemotherapy after concurrent chemoradiotherapy for oligometastatic stage IV non-small cell lung cancer

Abstract

Objective To evaluate the efficacy and safety of consolidation chemotherapy after thoracic radical concurrent chemoradiotherapy for patients with oligometastatic non-small cell lung cancer (NSCLC). Methods Sixty-six NSCLC patients with more than five metastases from 2008 to 2013 were enrolled, and image-guided radiotherapy with conventionally fractionated or hypofractionated doses were performed for these patients. Platinum-based doublets chemotherapy was applied for both concurrent chemoradiotherapy and consolidation chemotherapy. Short-term outcome, adverse reactions, and survival rate were assessed for the patients after treatment. Results Sixty-four patients completed the treatment. The median biologically equivalent dose for planning target volume of thoracic primary tumor lesions was 72 Gy, with a median number of chemotherapy cycles of 4. The objective response rate for thoracic lesions was 70%. The follow-up rate was 97%. The 1-, 2-, and 3-year overall survival (OS) rates were 72%, 53%, and 31%, respectively, with a median OS time of 25 months; the 1-, 2-, and 3-year progression-free survival (PFS) rates were 56%, 26%, and 7%, respectively, with a median PFS time of 14 months. The incidence of grade 2-3 acute radiation pneumonitis and radiation esophagitis was 1% and 17%, respectively, and the incidence of grade 3-4 decreases in leukocytes, hemoglobin, and platelet count was 39%, 11%, and 16%, respectively. Conclusions Radical radiotherapy combined with concurrent and consolidation chemotherapy for oligometastatic NSCLC can achieve good short-term outcome and long-term survival, with tolerable adverse effects. Key words: Lung neoplasms/radiochemotherapy; Oligometastatic; Treatment outcome; Toxicity