title: Randomised trial of sequential versus concurrent chemo-radiotherapy in patients with inoperable non-small cell lung cancer (EORTC 08972-22973).
abstract: A randomised phase III study was performed comparing sequential (S) and concurrent (C) chemo-radiotherapy (CRT) in non-small cell lung cancer (NSCLC) patients.
  
  
  METHODS
  One hundred and fifty-eight patients were randomised to receive two courses of Gemcitabine (1250mg/m(2) days 1, 8) and Cisplatin (75mg/m(2) day 2) prior to, or daily low-dose Cisplatin (6mg/m(2)) concurrent with radiotherapy, consisting of 24 fractions of 2.75Gy in 32 days, with a total dose of 66Gy.
  
  
  RESULTS
  Acute haematological toxicity grade 3/4 was more pronounced in the sequential (S) (30% versus 6%), oesophagitis grade 3/4 more frequent in the concurrent (C) arm (5% versus 14%). Late oesophagitis grade 3 was 4% (S and C), pneumonitis grade 3/4 14% (S) and 18% (C). Because of the poor power of the study no significant differences in median survival (MS), overall survival (OS) and progression-free survival (PFS) could be detected. MS was 16.2 (S) and 16.5 (C) months, 2-year OS was 34% (S) and 39% (C), 3-year OS was 22% (S) and 34% (C).
  
  
  CONCLUSIONS
  Radiotherapy 66Gy given concurrently with daily low-dose Cisplatin or after two courses of Gemcitabine/Cisplatin was well tolerated. Due to early closure no conclusions can be reached on the relative merits; both arms showed good OS.
authors.affiliation: Department of Radiation Oncology, The Netherlands Cancer Institute - Antoni Van Leeuwenhoek Hospital, Amsterdam, The Netherlands. j.belderbos@nki.nl
authors.forename: José
authors.initials: J
authors.lastname: Belderbos
authors.forename: Lon
authors.initials: L
authors.lastname: Uitterhoeve
authors.forename: Nico
authors.initials: N
authors.lastname: van Zandwijk
authors.forename: Huub
authors.initials: H
authors.lastname: Belderbos
authors.forename: Patrick
authors.initials: P
authors.lastname: Rodrigus
authors.forename: Paul
authors.initials: P
authors.lastname: van de Vaart
authors.forename: Allan
authors.initials: A
authors.lastname: Price
authors.forename: Nico
authors.initials: N
authors.lastname: van Walree
authors.forename: Catherine
authors.initials: C
authors.lastname: Legrand
authors.forename: Sonia
authors.initials: S
authors.lastname: Dussenne
authors.forename: Harry
authors.initials: H
authors.lastname: Bartelink
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Giaccone
authors.forename: Caro
authors.initials: C
authors.lastname: Koning
mesh_terms: D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000532:radiotherapy*; D003131:Combined Modality Therapy / Q000379:methods; D018572:Disease-Free Survival; D005260:Female; D006402:Hematologic Diseases / Q000209:etiology; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D016019:Survival Analysis; D016896:Treatment Outcome