Comparison of concurrent and sequential chemoradiotherapy for locally advanced non-small cell lung cancer

Abstract

Objective To compare the effectiveness of concurrent chemoradiotherapy and sequential chemoradiotherapy in locally advanced non-small cell lung cancer (NSCLC).Methods From March 2002 to October 2012,121 patients with stage Ⅲ NSCLC in Peking Union Medical College Hospital were enrolled into concurrent chemoradiotherapy group and sequential chemoradiotherapy group.Objective response rate (ORR),overall survival (OS),and progression-free survival (PFS) were compared between two groups.Enumeration data were analyzed by Chi-Square test,the mean of samples by t-test,and OS and PFS by Kaplan-Meier test.Results Among 121 patients with stage Ⅲ NSCLC,66 patients received concurrent chemoradiotherapy and 55 patients received sequential chemoradiotherapy.The median OS and PFS of the whole group were 23.1 and 10.7 months.In concurrent chemoradiotherapy group and sequential chemoradiotherapy group,ORR was 45.5％ and 16.4％,the disease control rate (DCR) was 84.8％ and 61.8％,the median OS was 33.4 and 19.7 months,and the median PFS was 12.7 and 9.8 months,there were significant differences between two groups (x2 =10.128,P ＜0.05).In concurrent chemoradiotherapy group,ten patients received surgery after chemoradiotherapy.The median OS and PFS did not arrival.Conclusions Compared with sequential chemoradiotherapy,concurrent chemoradiotherapy can significantly increase the ORR,DCR,OS,and PFS for patients with locally advanced NSCLC.Surgery after concurrent chemoradiotherapy may prolong the survival in carefully selected patients. Key words: Locally advanced non-small cell lung cancer; Concurrent chemoradiotherapy; Sequential chemoradiotherapy