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Published on: February 12, 2017
Three-times daily radiotherapy after chemotherapy in stage III non-small cell lung cancer. Single-institution
Gianpiero Catalano1, Tommaso De Pas, Lorenzo Spaggiari
1Division of Radiotherapy, European Institute of Oncology, Milan, Italy. gianpiero.catalano@ieo.it
Aim:
A prospective study for stage IIIA-B nonsmall cell lung cancer (NSCLC), with three-times daily (3td) radiotherapy (RT), after induction chemotherapy (iCT), with or without surgery.
Patients And Methods:
Induction cisplatin and gemcitabine chemotherapy was delivered. Surgery and postoperative (post-op) radiotherapy were planned for responsive stage IIIA patients; definitive irradiation was performed in unresectable IIIA and IIIB patients. Doses of 54.4 and 64.6 Gy were delivered for the post-op and definitive treatments, respectively.
Results:
Out of 52 patients (pts), 37 received 3tdRT as definitive (18 pts) or post-op treatment (19 pts). Overall, the failures were similar between post-op and definitive 3tdRT (78.9% vs. 77.8%). In the post-op treatment, metastases and local failures were 52.6% and 10.5%, respectively and in the definitive radiotherapy, the incidence was similar (local 33.3% vs. systemic 44.4%). The five-year overall survival (OS) was 25% for the post-op and 21% for the definitive patients (p = 0.87).
Conclusion:
Three-times daily postoperative radiotherapy did not improve the outcome in NSCLC, but for unresectable patients, this approach may have a role in selected cases.
