Abstract
BackgroundFor patients with locally advanced non-small-cell lung cancer (LA-NSCLC), the role of consolidation chemotherapy (CCT) following concurrent chemoradiotherapy (CRT) is partially defined. The aim of this study was to evaluate the efficacy and toxicity of CCT.MethodsThe characteristics of LA-NSCLC patients treated with curative concurrent CRT from 2001 to 2010 were retrospectively reviewed.ResultsAmong 203 patients, 113 (55.7 %) patients received CCT. The median number of delivered CCT was 3 and 89.4 % patients completed ≥2 cycles. The OS was significantly better for patients in the CCT group compared with that in the non-CCT group (median OS, 27 months vs. 16 months; 5-year OS, 30.4 % vs. 22.5 %; p = 0.012). The median PFS were 12 months in the CCT group and 9 months in the non-CCT group (p = 0.291). The survival advantages of CCT were significant for males (HR: 0.63; 95 % CI, 0.44 − 0.90), patients with age < 60 years (HR: 0.63; 95 % CI, 0.42 − 0.95), non-squamous histology (HR: 0.44; 95 % CI, 0.25 − 0.76), pretreatment KPS ≥ 80 (HR: 0.67; 95 % CI, 0.48 − 0.93), stage IIIb (HR: 0.64; 95 % CI, 0.43 − 0.95), stable disease (HR: 0.31; 95 % CI, 0.14 − 0.65) and radiotherapy dose ≥ 60 Gy (HR: 0.69; 95 % CI, 0.48 − 1.00). There was no significant difference between the CCT group and the non-CCT group regarding treatment-related toxicities.ConclusionsCCT might further prolong survival compared with CRT alone for LA-NSCLC without increasing treatment-related toxicities, especially for males, patients with age < 60 years, non-squamous histology, pretreatment KPS ≥ 80, stage IIIb, stable disease and radiotherapy dose ≥ 60 Gy. Large size prospective investigations that incorporate patient characteristics and treatment response are warranted to validate our findings.Electronic supplementary materialThe online version of this article (doi:10.1186/s12885-015-1710-2) contains supplementary material, which is available to authorized users.
Highlights
For patients with locally advanced non-small-cell lung cancer (LA-Non-small-cell lung cancer (NSCLC)), the role of consolidation chemotherapy (CCT) following concurrent chemoradiotherapy (CRT) is partially defined
We excluded 17 patients whose response assessments were unavailable, 13 patients who experienced disease progression within a month after concurrent CRT, 18 patients whose concurrent chemotherapy did not consist of platinum doublet regimens and 10 patients who were treated with conventional two-dimensional radiotherapy; a total of 203 patients were available for analysis
The multinational CCheIN trial [10] reported that consolidation Docetaxel plus cisplatin (DP) after concurrent weekly DP resulted in a Progressionfree survival (PFS) and a Overall survival (OS) that were similar to those of the observation group
Summary
For patients with locally advanced non-small-cell lung cancer (LA-NSCLC), the role of consolidation chemotherapy (CCT) following concurrent chemoradiotherapy (CRT) is partially defined. The outcome of LA-NSCLC treated with concurrent chemoradiotherapy (CRT) remains disappointing, with a median survival of 12–23.2 months [6, 7]. Numerous studies have focused on exploring the feasibility and efficacy of consolidation chemotherapy (CCT) following concurrent CRT with discordant results. A phase II study of the Southwest Oncology Group (SWOG) 9504 [8] treated patients with concurrent CRT followed by consolidation docetaxel and achieved a promising median survival of 26 months suggesting a possible benefit of CCT. Given the lack of substantial evidence from randomized phase III clinical trials, the definitive role of CCT in LA-NSCLC is unknown, especially in the Asian population. Our study attempted to evaluate the efficacy and toxicity of CCT after concurrent CRT at our institution
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